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General NPI Number Information
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NPI Number | 1952752396
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Entity Type | Organization
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Legal Business Name | INTERSTATE URGENT CARE MEDICAL GROUP INC.
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 12134 VICTORY BLVD STE B
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3205
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Country | US
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Telephone | 323-921-6309
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Fax |
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Provider Business Mailing Address
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Address Line | 12134 VICTORY BLVD STE B
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3205
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Country | US
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Telephone | 323-921-6309
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | HERMAN BELL
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Credential | DO
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Telephone | 323-921-6309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20A5193
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License Number State | CA
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