Provider Demographics
NPI:1356650386
Name:CENTRAL URGENT MEDICAL CARE
Entity type:Organization
Organization Name:CENTRAL URGENT MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THUY ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN-VO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-297-3361
Mailing Address - Street 1:8891 CENTRAL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-1618
Mailing Address - Country:US
Mailing Address - Phone:909-297-3361
Mailing Address - Fax:909-621-1397
Practice Address - Street 1:8891 CENTRAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-1618
Practice Address - Country:US
Practice Address - Phone:909-297-3361
Practice Address - Fax:909-621-1397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21127261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care