Provider Demographics
NPI:1528510062
Name:URGENT CARE TRAVEL, INC
Entity type:Organization
Organization Name:URGENT CARE TRAVEL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-471-3753
Mailing Address - Street 1:9903 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 4500
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1671
Mailing Address - Country:US
Mailing Address - Phone:310-471-3753
Mailing Address - Fax:
Practice Address - Street 1:10650 SIERRA AVE STE B
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-7664
Practice Address - Country:US
Practice Address - Phone:310-471-3753
Practice Address - Fax:310-943-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care