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NPI Code Detail

MEDICARE: MALIBU CANYON URGENT CARE LLC

MEDICARE: MALIBU CANYON URGENT CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1356931760
Entity Type Code : Organization
Provider Name (Legal Business Name) : MALIBU CANYON URGENT CARE LLC
Provider Business Mailing Address
First Line : 5673 LAS VIRGENES RD
Second Line :
City : CALABASAS
State : CA
Zip : 91302-1069
Country : US
Telephone Number : 818-919-4175
Fax Number :
Provider Business Practice Location Address
First Line : 5673 LAS VIRGENES RD
Second Line :
City : CALABASAS
State : CA
Zip : 91302-1069
Country : US
Telephone Number : 818-919-4175
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SALVADOR PLASENCIA
Credential : MD
Telephone Number : 818-919-4175
Provider Enumeration Date : 01/20/2021
Last Update Date : 07/01/2022

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Directions to “MALIBU CANYON URGENT CARE LLC ” Practice Location

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