Provider Demographics
NPI:1972863611
Name:WILMINGTON URGENT CARE AND FAMILY CLINIC INC
Entity type:Organization
Organization Name:WILMINGTON URGENT CARE AND FAMILY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KAHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-522-4200
Mailing Address - Street 1:714 N. AVALON BLVD.
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744
Mailing Address - Country:US
Mailing Address - Phone:310-522-4200
Mailing Address - Fax:310-522-4224
Practice Address - Street 1:714 N AVALON BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5809
Practice Address - Country:US
Practice Address - Phone:310-522-4200
Practice Address - Fax:310-522-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-28
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97561261QU0200X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care