Provider Demographics
NPI:1215365754
Name:MORENO VALLEY URGENT CARE CLINIC, INC
Entity Type:Organization
Organization Name:MORENO VALLEY URGENT CARE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNET / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-243-5050
Mailing Address - Street 1:24318 HEMLOCK AVE
Mailing Address - Street 2:SUITE E1
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1744 UNIVERSITY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-5364
Practice Address - Country:US
Practice Address - Phone:951-243-5586
Practice Address - Fax:951-243-5050
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORENO VALLEY URGENT CARE CLINIC, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA4349261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care