Provider Demographics
NPI:1053500058
Name:AMERICAN CURRENT CARE OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:AMERICAN CURRENT CARE OF CALIFORNIA, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TOM
Authorized Official - Last Name:FOGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-232-3550
Mailing Address - Street 1:5080 SPECTRUM DRIVE
Mailing Address - Street 2:SUITE 1200 WEST
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4625
Mailing Address - Country:US
Mailing Address - Phone:800-232-3550
Mailing Address - Fax:972-387-8058
Practice Address - Street 1:110 SUTTER STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104
Practice Address - Country:US
Practice Address - Phone:415-781-7077
Practice Address - Fax:415-781-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ07334ZMedicare PIN
CACE787DMedicare PIN