Provider Demographics
NPI:1851564215
Name:SANTA FE SPRINGS URGENT CARE
Entity Type:Organization
Organization Name:SANTA FE SPRINGS URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.N.P.
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN / FNP
Authorized Official - Phone:909-357-3465
Mailing Address - Street 1:17165 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1526
Mailing Address - Country:US
Mailing Address - Phone:909-357-3465
Mailing Address - Fax:
Practice Address - Street 1:11460 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3142
Practice Address - Country:US
Practice Address - Phone:562-864-1000
Practice Address - Fax:562-864-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481425261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15500Medicare UPIN