Provider Demographics
NPI:1972024388
Name:FAMILY URGENT CARE INC
Entity Type:Organization
Organization Name:FAMILY URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANCE
Authorized Official - Prefix:
Authorized Official - First Name:KILANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SUHEIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-610-2584
Mailing Address - Street 1:103 N BROOKHURST ST STE 103
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5605
Mailing Address - Country:US
Mailing Address - Phone:657-217-1913
Mailing Address - Fax:
Practice Address - Street 1:103 N BROOKHURST ST STE 103
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5605
Practice Address - Country:US
Practice Address - Phone:657-217-1913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48947261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18023OtherMEDICAL BOARD OF CALIFORNIA