Provider Demographics
NPI:1700247335
Name:PERALTA URGENT CARE
Entity Type:Organization
Organization Name:PERALTA URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZELALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:YILMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-616-2500
Mailing Address - Street 1:6740 S KINGS RANCH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-2961
Mailing Address - Country:US
Mailing Address - Phone:480-616-2500
Mailing Address - Fax:480-845-1008
Practice Address - Street 1:6740 S KINGS RANCH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-2961
Practice Address - Country:US
Practice Address - Phone:480-616-2500
Practice Address - Fax:480-845-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care