Provider Demographics
NPI:1639413388
Name:BREA URGENT CARE INCORPORATED
Entity Type:Organization
Organization Name:BREA URGENT CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-752-6300
Mailing Address - Street 1:395 WEST CENTRAL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821
Mailing Address - Country:US
Mailing Address - Phone:949-752-6300
Mailing Address - Fax:
Practice Address - Street 1:395 WEST CENTRAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821
Practice Address - Country:US
Practice Address - Phone:949-752-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care