Provider Demographics
NPI:1205186442
Name:ACTION URGENT CARE INC
Entity Type:Organization
Organization Name:ACTION URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:G
Authorized Official - Last Name:SKOROKHOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-827-6130
Mailing Address - Street 1:1375 BLOSSOM HILL RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3806
Mailing Address - Country:US
Mailing Address - Phone:626-791-9004
Mailing Address - Fax:626-791-9005
Practice Address - Street 1:1375 BLOSSOM HILL RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3806
Practice Address - Country:US
Practice Address - Phone:626-791-9004
Practice Address - Fax:626-791-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98375261QU0200X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No291U00000XLaboratoriesClinical Medical Laboratory