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General NPI Number Information
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NPI Number | 1962663393
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Entity Type | Organization
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Legal Business Name | TOWN CENTER PLAZA URGENT CARE INC
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 19015 TOWN CENTER DRIVE SUITE 102
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City | APPLE VALLEY
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State | CA
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Zip | 92308
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Country | US
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Telephone | 760-247-4175
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Fax | 760-247-3986
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Provider Business Mailing Address
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Address Line | 19015 TOWN CENTER DR SUITE 102
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City | APPLE VALLEY
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State | CA
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Zip | 92308
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Country | US
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Telephone | 760-247-4175
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Fax | 760-247-3986
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. NANCY A GLASS
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Credential | MA
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Telephone | 760-247-0581
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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 | A46329
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License Number State | CA
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