Provider Demographics
NPI:1568645935
Name:GENERATIONS WELLNESS AND URGENT CARE APMC
Entity Type:Organization
Organization Name:GENERATIONS WELLNESS AND URGENT CARE APMC
Other - Org Name:GENERATIONS WELLNESS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:831-662-9355
Mailing Address - Street 1:9515 SOQUEL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4135
Mailing Address - Country:US
Mailing Address - Phone:831-662-9355
Mailing Address - Fax:831-662-9358
Practice Address - Street 1:9515 SOQUEL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4135
Practice Address - Country:US
Practice Address - Phone:831-662-9355
Practice Address - Fax:831-662-9358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-09
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40989261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care