Provider Demographics
NPI:1326270588
Name:R-C URGENT CARE FAMILY PRACTICE INC
Entity Type:Organization
Organization Name:R-C URGENT CARE FAMILY PRACTICE INC
Other - Org Name:LA QUINTA IMMEDIATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR / VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TENGIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-398-7800
Mailing Address - Street 1:PO BOX 5897
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92248-5897
Mailing Address - Country:US
Mailing Address - Phone:760-398-7800
Mailing Address - Fax:760-398-7802
Practice Address - Street 1:79440 CORPORATE CENTER DR
Practice Address - Street 2:SUITE 118
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-7241
Practice Address - Country:US
Practice Address - Phone:760-398-7800
Practice Address - Fax:760-398-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty