Provider Demographics
NPI:1407210958
Name:A PLUS WALK IN URGENT CARE
Entity Type:Organization
Organization Name:A PLUS WALK IN URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-696-7587
Mailing Address - Street 1:617 E ALVARADO ST
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2315
Mailing Address - Country:US
Mailing Address - Phone:951-696-7587
Mailing Address - Fax:951-397-4240
Practice Address - Street 1:41880 KALMIA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8831
Practice Address - Country:US
Practice Address - Phone:951-696-7587
Practice Address - Fax:951-461-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A67751Medicare PIN