Provider Demographics
NPI:1164559696
Name:WALNUT CREEK URGENT CARE
Entity Type:Organization
Organization Name:WALNUT CREEK URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:H VIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-930-8200
Mailing Address - Street 1:112 LA CASA VIA STE 135
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3023
Mailing Address - Country:US
Mailing Address - Phone:925-930-8200
Mailing Address - Fax:
Practice Address - Street 1:112 LA CASA VIA STE 135
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3023
Practice Address - Country:US
Practice Address - Phone:925-930-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48594261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31099ZMedicare PIN
CAF00105Medicare UPIN
CA00A485941Medicare PIN