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General NPI Number Information
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NPI Number | 1922876291
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Entity Type | Organization
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Legal Business Name | QUICLINICS MEDICAL PARTNERS
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 3560 FAIRMOUNT AVE STE B
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City | SAN DIEGO
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State | CA
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Zip | 92105-3420
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Country | US
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Telephone | 949-786-2004
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Fax |
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Provider Business Mailing Address
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Address Line | 5319 UNIVERSITY DR STE 232
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City | IRVINE
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State | CA
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Zip | 92612-2965
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Country | US
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Telephone | 949-786-2004
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JAY FRANCIS LAMOTHE JR.
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Credential | ED
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Telephone | 949-786-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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