| Palmdale Urgent Care Inc | |
|
2270 E Palmdale Blvd Ste F Palmdale CA 93550-1334 | |
| (661) 855-4044 | |
| Not Available |
| Full Name | Palmdale Urgent Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2270 E Palmdale Blvd Ste F, Palmdale, California |
| Authorized Official Name and Position | Richard Park (OWNER/PRESIDENT) |
| Authorized Official Contact | 6618554044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmdale Urgent Care Inc 2270 E Palmdale Blvd Ste F Palmdale CA 93550-1334 Ph: (661) 855-4044 | Palmdale Urgent Care Inc 2270 E Palmdale Blvd Ste F Palmdale CA 93550-1334 Ph: (661) 855-4044 |
| NPI Number | 1699480038 |
|---|---|
| Provider Enumeration Date | 01/19/2023 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 6901262989 |
|---|---|
| Medicare Enrollment ID | O20230517001227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699480038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Richard Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174718134 PECOS PAC ID: 5698964906 Enrollment ID: I20110118000516 |
| Provider Name | Vanessa Tabungar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760046924 PECOS PAC ID: 0345570396 Enrollment ID: I20190918001481 |
| Provider Name | Philip Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356781132 PECOS PAC ID: 5496054330 Enrollment ID: I20200715002512 |
| Provider Name | Lovelle E Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205228699 PECOS PAC ID: 9739482563 Enrollment ID: I20210910002583 |
| Provider Name | Maribelle B. Abergas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104481704 PECOS PAC ID: 2062886344 Enrollment ID: I20230328003037 |
| Provider Name | Stacey Yvette Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073210514 PECOS PAC ID: 0648713461 Enrollment ID: I20240621001592 |
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