Provider Demographics
NPI:1558788620
Name:SOMAGEN HEALTHCARE III INC
Entity Type:Organization
Organization Name:SOMAGEN HEALTHCARE III INC
Other - Org Name:AFC URGENT CARE OF SAN DIEGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KEELER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:855-362-9773
Mailing Address - Street 1:5671 BALBOA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2705
Mailing Address - Country:US
Mailing Address - Phone:855-362-9773
Mailing Address - Fax:619-569-2590
Practice Address - Street 1:5671 BALBOA AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2705
Practice Address - Country:US
Practice Address - Phone:858-800-2880
Practice Address - Fax:619-569-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9655261QP2300X, 261QU0200X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine