Provider Demographics
NPI:1295205482
Name:QUICLINICS MEDICAL PARTNERS
Entity Type:Organization
Organization Name:QUICLINICS MEDICAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:F
Authorized Official - Last Name:LAMOTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-786-2004
Mailing Address - Street 1:5319 UNIVERSITY DR # 232
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2965
Mailing Address - Country:US
Mailing Address - Phone:949-786-2004
Mailing Address - Fax:
Practice Address - Street 1:1075 E PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5089
Practice Address - Country:US
Practice Address - Phone:949-786-2004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUICLINICS MEDICAL PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-29
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health