Provider Demographics
NPI:1811599830
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
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 1:1300 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7504
Mailing Address - Country:US
Mailing Address - Phone:323-464-1336
Mailing Address - Fax:
Practice Address - Street 1:3932 LONG BEACH BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2615
Practice Address - Country:US
Practice Address - Phone:562-855-2800
Practice Address - Fax:562-855-2801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANAHEIM URGENT CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care