Provider Demographics
NPI:1851668800
Name:CARE 1ST PRIMARY AND URGENT CARE CENTER - PALMDALE
Entity Type:Organization
Organization Name:CARE 1ST PRIMARY AND URGENT CARE CENTER - PALMDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-575-2725
Mailing Address - Street 1:38440 5TH ST W
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4498
Mailing Address - Country:US
Mailing Address - Phone:661-575-2725
Mailing Address - Fax:
Practice Address - Street 1:38440 5TH STREET WEST
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4684
Practice Address - Country:US
Practice Address - Phone:661-575-2725
Practice Address - Fax:661-273-2139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE1ST HEALTH PLAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-18
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 261QP2300X
CA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty