Provider Demographics
NPI:1700192192
Name:AAA URGENT CARE LLC
Entity Type:Organization
Organization Name:AAA URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GATUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-425-8898
Mailing Address - Street 1:14400 ROSCOE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-3001
Mailing Address - Country:US
Mailing Address - Phone:818-704-4213
Mailing Address - Fax:
Practice Address - Street 1:14400 ROSCOE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-3001
Practice Address - Country:US
Practice Address - Phone:818-704-4213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care