Provider Demographics
NPI:1477848141
Name:FAMILY & URGENT CARE MEDICAL CENTER
Entity Type:Organization
Organization Name:FAMILY & URGENT CARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-666-2220
Mailing Address - Street 1:1200 N VERMONT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1760
Mailing Address - Country:US
Mailing Address - Phone:323-666-2220
Mailing Address - Fax:323-666-2226
Practice Address - Street 1:1200 N VERMONT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1760
Practice Address - Country:US
Practice Address - Phone:323-666-2220
Practice Address - Fax:323-666-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service