Provider Demographics
NPI:1891917944
Name:SEAL BEACH URGENT CARE MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SEAL BEACH URGENT CARE MEDICAL CORPORATION
Other - Org Name:SEAL BEACH URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-598-2904
Mailing Address - Street 1:1198 PACIFIC COAST HWY
Mailing Address - Street 2:SUITE J
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6251
Mailing Address - Country:US
Mailing Address - Phone:562-598-2904
Mailing Address - Fax:562-594-5627
Practice Address - Street 1:1198 PACIFIC COAST HWY
Practice Address - Street 2:SUITE J
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6251
Practice Address - Country:US
Practice Address - Phone:562-598-2904
Practice Address - Fax:562-594-5627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care