Provider Demographics
NPI:1659810760
Name:CAL URGENT CARE, PC
Entity Type:Organization
Organization Name:CAL URGENT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-824-1545
Mailing Address - Street 1:6641 STANFORD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2674
Mailing Address - Country:US
Mailing Address - Phone:916-824-1545
Mailing Address - Fax:916-259-1847
Practice Address - Street 1:6641 STANFORD RANCH RD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677
Practice Address - Country:US
Practice Address - Phone:916-824-1545
Practice Address - Fax:916-259-2674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54508261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care