Provider Demographics
NPI:1841563160
Name:OC URGENT CARE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:OC URGENT CARE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAHLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-297-3888
Mailing Address - Street 1:PO BOX 2638
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92814-0638
Mailing Address - Country:US
Mailing Address - Phone:949-297-3888
Mailing Address - Fax:
Practice Address - Street 1:26781 PORTOLA PKWY
Practice Address - Street 2:4E
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1758
Practice Address - Country:US
Practice Address - Phone:949-297-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care