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General NPI Number Information
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NPI Number | 1982121307
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Entity Type | Organization
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Legal Business Name | WEST LOS ANGELES URGENT CARE
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 11560 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-1520
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Country | US
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Telephone | 310-477-8285
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Fax |
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Provider Business Mailing Address
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Address Line | 831 S STATE COLLEGE BLVD
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City | ANAHEIM
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State | CA
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Zip | 92806-4613
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Country | US
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Telephone | 714-533-2273
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Fax | 714-635-2273
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Authorized Official
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Title or Position | MANAGER
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Name | JAMALA PRATT
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Credential |
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Telephone | 714-533-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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