Basic Information
| Provider Information | |||||||||
| NPI: | 1891917944 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEAL BEACH URGENT CARE MEDICAL CORPORATION | ||||||||
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| OtherOrganizationName: | SEAL BEACH URGENT CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1198 PACIFIC COAST HWY | ||||||||
| Address2: | SUITE J | ||||||||
| City: | SEAL BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907406251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625982904 | ||||||||
| FaxNumber: | 5625945627 | ||||||||
| Practice Location | |||||||||
| Address1: | 1198 PACIFIC COAST HWY | ||||||||
| Address2: | SUITE J | ||||||||
| City: | SEAL BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907406251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625982904 | ||||||||
| FaxNumber: | 5625945627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 09/06/2007 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | TURNER | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5625982904 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.