Provider Demographics
NPI:1093232738
Name:PREMIER URGENT CARE OF CENTRAL CALIFORNIA
Entity Type:Organization
Organization Name:PREMIER URGENT CARE OF CENTRAL CALIFORNIA
Other - Org Name:WASCO HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION/MEDICAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-910-6890
Mailing Address - Street 1:1149 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WASCO
Mailing Address - State:CA
Mailing Address - Zip Code:93280-1819
Mailing Address - Country:US
Mailing Address - Phone:661-402-5002
Mailing Address - Fax:661-240-5526
Practice Address - Street 1:1149 7TH ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-1819
Practice Address - Country:US
Practice Address - Phone:661-402-5002
Practice Address - Fax:661-240-5526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty