Provider Demographics
NPI:1033400320
Name:ADVANCED URGENT CARE OF CITY LINE
Entity Type:Organization
Organization Name:ADVANCED URGENT CARE OF CITY LINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKPARVAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-921-6510
Mailing Address - Street 1:5058 CITY LINE AVE.
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19131
Mailing Address - Country:US
Mailing Address - Phone:215-921-6510
Mailing Address - Fax:215-921-6985
Practice Address - Street 1:5058 CITY LINE AVE.
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-921-6510
Practice Address - Fax:215-921-6985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty