Basic Information
Provider Information
NPI: 1699323634
EntityType: 2
ReplacementNPI:  
OrganizationName: EMERGENCY PHYSICIANS URGENT CARE INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6789 N BLACKSTONE AVE
Address2:  
City: FRESNO
State: CA
PostalCode: 937103530
CountryCode: US
TelephoneNumber: 6618296747
FaxNumber: 6618296937
Practice Location
Address1: 6789 N BLACKSTONE AVE
Address2:  
City: FRESNO
State: CA
PostalCode: 937103530
CountryCode: US
TelephoneNumber: 6618296747
FaxNumber: 6618296937
Other Information
ProviderEnumerationDate: 09/03/2019
LastUpdateDate: 09/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MASSIHI
AuthorizedOfficialFirstName: ARTIN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 6618296747
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: EMERGENCY PHYSICIANS URGENT CARE INC
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QU0200X  Y Ambulatory Health Care FacilitiesClinic/CenterUrgent Care

No ID Information.


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