Provider Demographics
NPI:1407609167
Name:MIRACLE TOUCH URGENT CARE
Entity Type:Organization
Organization Name:MIRACLE TOUCH URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:OKECHUKWU
Authorized Official - Last Name:EMENIKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-673-7200
Mailing Address - Street 1:4855 SANTA MONICA BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2654
Mailing Address - Country:US
Mailing Address - Phone:323-673-7200
Mailing Address - Fax:323-673-7209
Practice Address - Street 1:4855 SANTA MONICA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2654
Practice Address - Country:US
Practice Address - Phone:323-673-7200
Practice Address - Fax:323-673-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care