Provider Demographics
NPI:1053967612
Name:TUSTIN URGENT CARE, APC
Entity type:Organization
Organization Name:TUSTIN URGENT CARE, APC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZAID
Authorized Official - Middle Name:
Authorized Official - Last Name:NOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-243-5450
Mailing Address - Street 1:17612 17TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-1962
Mailing Address - Country:US
Mailing Address - Phone:714-243-5450
Mailing Address - Fax:
Practice Address - Street 1:12860 BEACH BLVD STE E
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-4084
Practice Address - Country:US
Practice Address - Phone:714-243-5450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUSTIN URGENT CARE, APC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-09
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty