Provider Demographics
NPI:1497977581
Name:BRIGHTON MEDICAL CLINIC
Entity Type:Organization
Organization Name:BRIGHTON MEDICAL CLINIC
Other - Org Name:BRIGHTON URGENT CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT BRIGHTON MEDICAL CLINIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OKUBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-655-3205
Mailing Address - Street 1:12700 EAST BIG COTTONWOOD CANYON ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:UT
Mailing Address - Zip Code:84121
Mailing Address - Country:US
Mailing Address - Phone:435-655-3205
Mailing Address - Fax:435-655-3205
Practice Address - Street 1:12700 EAST BIG COTTONWOOD CANYON ROAD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:UT
Practice Address - Zip Code:84121
Practice Address - Country:US
Practice Address - Phone:435-655-3205
Practice Address - Fax:435-655-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care