MEDICARE: SUNSET & VERMONT 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

General Provider Information

NPI Number	:	1821761578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSET & VERMONT URGENT CARE

Provider Business Mailing Address
First Line	:	1407 N VERMONT AVE STE B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6023
Country	:	US
Telephone Number	:	323-486-7021
Fax Number	:	323-967-2821

Provider Business Practice Location Address
First Line	:	1407 N VERMONT AVE STE B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6023
Country	:	US
Telephone Number	:	323-486-7021
Fax Number	:	323-967-2821

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH LOCHINVAR DINGLASAN SR.
Credential	:	MD
Telephone Number	:	909-723-0057

Provider Enumeration Date	:	07/28/2021
Last Update Date	:	07/28/2021

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