Provider Demographics
NPI:1689149577
Name:ANAHEIM URGENT CARE, INC.
Entity Type:Organization
Organization Name:ANAHEIM URGENT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-533-2273
Mailing Address - Street 1:831 S STATE COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-4613
Mailing Address - Country:US
Mailing Address - Phone:714-533-2273
Mailing Address - Fax:
Practice Address - Street 1:16818 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-3218
Practice Address - Country:US
Practice Address - Phone:714-533-2273
Practice Address - Fax:714-635-2273
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANAHEIM URGENT CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care