MEDICARE: SUNSET URGENT CARE, INC

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
1	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G45631	OTHER	CA	CALIFORNIA MEDICAL LICENS

General Provider Information

NPI Number	:	1407943566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSET URGENT CARE, INC

Provider Business Mailing Address
First Line	:	3689 EUREKA WAY
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-0177
Country	:	US
Telephone Number	:	530-247-4211
Fax Number	:	530-247-4241

Provider Business Practice Location Address
First Line	:	3689 EUREKA WAY
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-0177
Country	:	US
Telephone Number	:	530-247-4211
Fax Number	:	530-247-4241

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	WENDY M WALTON
Credential	:	CPC
Telephone Number	:	530-247-4211

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	01/26/2013

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