MEDICARE: EMERGENCY PHYSICIANS 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

General Provider Information

NPI Number	:	1497397632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERGENCY PHYSICIANS URGENT CARE INC

Provider Business Mailing Address
First Line	:	36290 HIDDEN SPRINGS RD STE D&E
Second Line	:
City	:	WILDOMAR
State	:	CA
Zip	:	92595-5802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36290 HIDDEN SPRINGS RD STE D&E
Second Line	:
City	:	WILDOMAR
State	:	CA
Zip	:	92595-5802
Country	:	US
Telephone Number	:	661-829-6747
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ARTIN MASSIHI
Credential	:
Telephone Number	:	661-829-6747

Provider Enumeration Date	:	10/09/2019
Last Update Date	:	10/09/2019

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