Provider Demographics
NPI:1265700157
Name:ALLIANCE URGENT CARE, INC
Entity type:Organization
Organization Name:ALLIANCE URGENT CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-929-6900
Mailing Address - Street 1:3853 W STETSON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-9674
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3853 W STETSON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-9674
Practice Address - Country:US
Practice Address - Phone:951-929-6900
Practice Address - Fax:951-929-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care