Provider Demographics
NPI:1366818023
Name:ANOOSHIRVAN BOZORGMEHR DO, INC
Entity Type:Organization
Organization Name:ANOOSHIRVAN BOZORGMEHR DO, INC
Other - Org Name:ALL VALLEY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANOOSHIRVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOZORGMEHR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:999-999-9999
Mailing Address - Street 1:2026 N IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-1607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2026 N IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1607
Practice Address - Country:US
Practice Address - Phone:999-999-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care