Provider Demographics
NPI:1740021716
Name:SMART URGENT CARE CENTER
Entity type:Organization
Organization Name:SMART URGENT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAE SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-604-2443
Mailing Address - Street 1:3800 WILSHIRE BLVD STE 207A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3233
Mailing Address - Country:US
Mailing Address - Phone:800-604-2443
Mailing Address - Fax:
Practice Address - Street 1:3800 WILSHIRE BLVD STE 207A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3233
Practice Address - Country:US
Practice Address - Phone:800-604-2443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care