Basic Information
Provider Information
NPI: 1760671762
EntityType: 2
ReplacementNPI:  
OrganizationName: AMERICAN CURRENT CARE OF CALIFORNIA, A MEDICAL CORPORATION
LastName:  
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Mailing Information
Address1: 5080 SPECTRUM DRIVE
Address2: SUITE 1200 WEST
City: ADDISON
State: TX
PostalCode: 750014625
CountryCode: US
TelephoneNumber: 8002323550
FaxNumber: 9723878058
Practice Location
Address1: 728 20TH STREET
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 94107
CountryCode: US
TelephoneNumber: 4156489501
FaxNumber: 4156489508
Other Information
ProviderEnumerationDate: 10/16/2007
LastUpdateDate: 07/01/2010
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: FOGARTY
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName: TOM
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8002323550
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QU0200X  N Ambulatory Health Care FacilitiesClinic/CenterUrgent Care
261Q00000X  Y Ambulatory Health Care FacilitiesClinic/Center 

No ID Information.


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