=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932593357
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOLAR URGENT CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2015
-----------------------------------------------------
Last Update Date | 05/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2100 SOLAR DR STE 100
-----------------------------------------------------
City | OXNARD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93036-0647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-988-9000
-----------------------------------------------------
Fax | 805-988-9089
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2100 SOLAR DR STE 100
-----------------------------------------------------
City | OXNARD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93036-0647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-988-9000
-----------------------------------------------------
Fax | 805-988-9089
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. ANDREW REZA LANGROUDI
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 805-988-9000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------