Provider Demographics
NPI:1376994533
Name:SHAFTER URGENT CARE
Entity Type:Organization
Organization Name:SHAFTER URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NOVIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-599-5310
Mailing Address - Street 1:501 MUNZER ST STE A
Mailing Address - Street 2:
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263-2042
Mailing Address - Country:US
Mailing Address - Phone:661-429-2739
Mailing Address - Fax:661-459-3535
Practice Address - Street 1:501 MUNZER ST STE A
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263
Practice Address - Country:US
Practice Address - Phone:661-429-2739
Practice Address - Fax:661-459-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68509261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care