Provider Demographics
NPI:1356856975
Name:ORANGE COUNTY URGENT CARE #3 INC.
Entity type:Organization
Organization Name:ORANGE COUNTY URGENT CARE #3 INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNATORY
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-600-4120
Mailing Address - Street 1:115 EASTPARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2311
Mailing Address - Country:US
Mailing Address - Phone:615-600-4074
Mailing Address - Fax:615-309-8341
Practice Address - Street 1:7330 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93442
Practice Address - Country:US
Practice Address - Phone:805-703-2501
Practice Address - Fax:805-703-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care