Provider Demographics
NPI:1073569109
Name:APPLE VALLEY URGENT CARE
Entity Type:Organization
Organization Name:APPLE VALLEY URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-241-7773
Mailing Address - Street 1:16003 TUSCOLA RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1319
Mailing Address - Country:US
Mailing Address - Phone:760-242-8400
Mailing Address - Fax:760-242-8859
Practice Address - Street 1:16003 TUSCOLA RD
Practice Address - Street 2:SUITE H
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1319
Practice Address - Country:US
Practice Address - Phone:760-242-8400
Practice Address - Fax:760-242-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty