Provider Demographics
NPI:1780816017
Name:MODESTO URGENT CARE INC
Entity Type:Organization
Organization Name:MODESTO URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:209-241-6308
Mailing Address - Street 1:PO BOX 2906
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95381-2906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1908 COFFEE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2719
Practice Address - Country:US
Practice Address - Phone:209-529-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89677261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care