Provider Demographics
NPI:1003114729
Name:WALK-IN CLINIC & DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:WALK-IN CLINIC & DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JING
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-614-8888
Mailing Address - Street 1:9449 N 90TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5099
Mailing Address - Country:US
Mailing Address - Phone:480-614-8888
Mailing Address - Fax:480-451-8886
Practice Address - Street 1:9449 N 90TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5099
Practice Address - Country:US
Practice Address - Phone:480-614-8888
Practice Address - Fax:480-451-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2710261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service