Provider Demographics
NPI:1265099584
Name:OHANA URGENT CARE GROUP, INC
Entity type:Organization
Organization Name:OHANA URGENT CARE GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:WAN I
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:760-448-6650
Mailing Address - Street 1:6260 EL CAMINO REAL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009
Mailing Address - Country:US
Mailing Address - Phone:760-448-6650
Mailing Address - Fax:760-448-6647
Practice Address - Street 1:6260 EL CAMINO REAL
Practice Address - Street 2:SUITE 101
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009
Practice Address - Country:US
Practice Address - Phone:760-448-6650
Practice Address - Fax:760-448-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care