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General NPI Number Information
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NPI Number | 1922541036
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Entity Type | Organization
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Legal Business Name | MINUTE CLINIC
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 11/21/2016
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Provider Practice Location Address
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Address Line | 683 LOMAS SANTA FE DR
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1412
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Country | US
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Telephone | 858-755-6697
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Fax |
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Provider Business Mailing Address
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Address Line | 7220 TEASDALE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92122-2829
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TRACIE LYNN NUSCA
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Credential |
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Telephone | 352-283-3717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 95005171
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License Number State | CA
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