Provider Demographics
NPI:1841501319
Name:SPECIALTY URGENT CARE, LP
Entity type:Organization
Organization Name:SPECIALTY URGENT CARE, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-365-2520
Mailing Address - Street 1:57402 29 PALMS HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2950
Mailing Address - Country:US
Mailing Address - Phone:760-365-2520
Mailing Address - Fax:760-365-2524
Practice Address - Street 1:57402 29 PALMS HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2950
Practice Address - Country:US
Practice Address - Phone:760-365-2520
Practice Address - Fax:760-365-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86692261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058988Medicare Oscar/Certification