Provider Demographics
NPI:1124796362
Name:EXECUTIVE URGENT CARE CENTERS INC
Entity type:Organization
Organization Name:EXECUTIVE URGENT CARE CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BOHDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLESNICKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-464-2131
Mailing Address - Street 1:74785 HWY 111, STE 100
Mailing Address - Street 2:
Mailing Address - City:INDIAN WELLS
Mailing Address - State:CA
Mailing Address - Zip Code:92210
Mailing Address - Country:US
Mailing Address - Phone:760-346-3932
Mailing Address - Fax:
Practice Address - Street 1:74785 HWY 111, SUITE 100
Practice Address - Street 2:
Practice Address - City:INDIAN WELLS
Practice Address - State:CA
Practice Address - Zip Code:92210
Practice Address - Country:US
Practice Address - Phone:760-346-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty