Provider Demographics
NPI:1306214184
Name:NELLIE GAIL URGENT CARE
Entity Type:Organization
Organization Name:NELLIE GAIL URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIMKHANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-600-1907
Mailing Address - Street 1:27001 MOULTON PKWY
Mailing Address - Street 2:A102
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3600
Mailing Address - Country:US
Mailing Address - Phone:949-600-1907
Mailing Address - Fax:
Practice Address - Street 1:27001 MOULTON PKWY
Practice Address - Street 2:A102
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92656-3600
Practice Address - Country:US
Practice Address - Phone:949-600-1907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101191261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care