Provider Demographics
NPI:1114531035
Name:Q & M PHYSICIAN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:Q & M PHYSICIAN MEDICAL CORPORATION
Other - Org Name:UNIVERSITY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUYEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DESPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-397-0706
Mailing Address - Street 1:941 KENDALL DR STE C
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-4156
Mailing Address - Country:US
Mailing Address - Phone:909-726-3200
Mailing Address - Fax:909-726-1010
Practice Address - Street 1:941 KENDALL DR STE C
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-4156
Practice Address - Country:US
Practice Address - Phone:951-316-8406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care