Provider Demographics
NPI:1457864464
Name:BAWJ MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:BAWJ MEDICAL SERVICES INC
Other - Org Name:PERRIS COMMUNITY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:909-228-4221
Mailing Address - Street 1:255 TERRACINA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4870
Mailing Address - Country:US
Mailing Address - Phone:909-228-4221
Mailing Address - Fax:909-307-1231
Practice Address - Street 1:520 W 4TH ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570
Practice Address - Country:US
Practice Address - Phone:909-228-4221
Practice Address - Fax:909-307-1231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54962207R00000X
261QU0200X
CA95003812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty