Organization Name: | OCEANSIDE URGENT CARE AND FAMILY PRACTICE |
NPI Number: | 1578991097 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH THOMAS (OWNER) |
Mailing Address: | 616 S Coast Hwy Oceanside |
State: | CA US |
Postal Code: | 920544121 |
Phone Number: | 7604331800 |
Fax Number: | 7602319900 |
NPI Enumeration Date: | 10/18/2013 |
NPI Last Update Date: | 10/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A44107 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |