MEDICARE: SUN VALLEY URGENT CARE

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538645403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUN VALLEY URGENT CARE

Provider Business Mailing Address
First Line	:	8426 SUNLAND BLVD
Second Line	:
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-3436
Country	:	US
Telephone Number	:	818-504-8234
Fax Number	:

Provider Business Practice Location Address
First Line	:	8426 SUNLAND BLVD
Second Line	:
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-3436
Country	:	US
Telephone Number	:	818-635-4796
Fax Number	:

Authorized Official
Title or Position	:	O
Name	:	A A
Credential	:
Telephone Number	:	818-504-8234

Provider Enumeration Date	:	07/13/2018
Last Update Date	:	09/09/2019

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Directions to “SUN VALLEY URGENT CARE ” Practice Location

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