Provider Demographics
NPI:1477376028
Name:SIMI VALLEY URGENT CARE INC
Entity type:Organization
Organization Name:SIMI VALLEY URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:SULTANA
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-272-6590
Mailing Address - Street 1:1350 E LOS ANGELES AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2898
Mailing Address - Country:US
Mailing Address - Phone:818-854-0759
Mailing Address - Fax:
Practice Address - Street 1:1350 E LOS ANGELES AVE STE 100
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2898
Practice Address - Country:US
Practice Address - Phone:805-272-6590
Practice Address - Fax:805-272-6591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty