Provider Demographics
NPI:1437792264
Name:AMOS K LADOUCEUR MD INC
Entity Type:Organization
Organization Name:AMOS K LADOUCEUR MD INC
Other - Org Name:WEEKEND URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMOS
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:LADOUCEUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-648-9308
Mailing Address - Street 1:5419 HOLLYWOOD BLVD STE 224
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-3480
Mailing Address - Country:US
Mailing Address - Phone:267-648-9308
Mailing Address - Fax:
Practice Address - Street 1:3750 SANTA ROSALIA DR UNIT 1
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3627
Practice Address - Country:US
Practice Address - Phone:310-910-7221
Practice Address - Fax:310-910-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty