Provider Demographics
NPI:1225407596
Name:TUSTIN URGENT CARE, APC
Entity Type:Organization
Organization Name:TUSTIN URGENT CARE, APC
Other - Org Name:XPRESS URGENT CARE TUSTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAID
Authorized Official - Middle Name:
Authorized Official - Last Name:NOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-243-5450
Mailing Address - Street 1:17612 E. 17TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-1937
Mailing Address - Country:US
Mailing Address - Phone:714-243-5450
Mailing Address - Fax:714-838-8944
Practice Address - Street 1:17612 E. 17TH ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-1937
Practice Address - Country:US
Practice Address - Phone:714-243-5450
Practice Address - Fax:714-838-8944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1306028907Medicare NSC
CA1306028907Medicare Oscar/Certification