Provider Demographics
NPI:1912590803
Name:OPTIMA URGENT CARE INC
Entity Type:Organization
Organization Name:OPTIMA URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHAVARZI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:760-691-9392
Mailing Address - Street 1:5256 S MISSION RD STE 1201
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-3624
Mailing Address - Country:US
Mailing Address - Phone:760-502-0911
Mailing Address - Fax:760-502-0912
Practice Address - Street 1:5256 S MISSION RD STE 1201
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-3624
Practice Address - Country:US
Practice Address - Phone:760-502-0911
Practice Address - Fax:760-502-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care