Provider Demographics
NPI:1598794331
Name:ACCESS MEDICAL CARE A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ACCESS MEDICAL CARE A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:PICO URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-654-2828
Mailing Address - Street 1:6632 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3533
Mailing Address - Country:US
Mailing Address - Phone:562-654-2828
Mailing Address - Fax:562-654-2830
Practice Address - Street 1:6632 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3533
Practice Address - Country:US
Practice Address - Phone:562-654-2828
Practice Address - Fax:562-654-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14042Medicare PIN