Provider Demographics
NPI:1932257920
Name:STUDIO CITY URGENT CARE AND MEDICAL CENTER
Entity Type:Organization
Organization Name:STUDIO CITY URGENT CARE AND MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAZRICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-761-1800
Mailing Address - Street 1:12660 RIVERSIDE DR
Mailing Address - Street 2:STE. 110
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3429
Mailing Address - Country:US
Mailing Address - Phone:818-761-1800
Mailing Address - Fax:818-761-1811
Practice Address - Street 1:12660 RIVERSIDE DR
Practice Address - Street 2:STE. 110
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91607-3429
Practice Address - Country:US
Practice Address - Phone:818-761-1800
Practice Address - Fax:818-761-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17060Medicare PIN
CAW17060Medicare ID - Type UnspecifiedMEDICARE GROUP NO