Provider Demographics
NPI:1629533955
Name:HAWAIIAN GARDENS WALK-IN URGENT CARE
Entity Type:Organization
Organization Name:HAWAIIAN GARDENS WALK-IN URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AMABLE
Authorized Official - Middle Name:DELOS REYES
Authorized Official - Last Name:AGUILUZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:562-860-2442
Mailing Address - Street 1:21500 S. PIONEER BLVD
Mailing Address - Street 2:STE #209
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-2600
Mailing Address - Country:US
Mailing Address - Phone:562-860-2442
Mailing Address - Fax:657-337-5057
Practice Address - Street 1:21500 S. PIONEER BLVD
Practice Address - Street 2:STE #209
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-2600
Practice Address - Country:US
Practice Address - Phone:562-860-2442
Practice Address - Fax:657-337-5057
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMABLE DELOS REYES AGUILUZ JR., M.D. INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care