Provider Demographics
NPI:1679083182
Name:QUICLINICS MEDICAL PARTNERS
Entity type:Organization
Organization Name:QUICLINICS MEDICAL PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:F
Authorized Official - Last Name:LAMOTHE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:949-293-7072
Mailing Address - Street 1:5319 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2965
Mailing Address - Country:US
Mailing Address - Phone:949-293-7072
Mailing Address - Fax:
Practice Address - Street 1:3620 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2607
Practice Address - Country:US
Practice Address - Phone:949-786-2004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health