| Urgent Doc Pro | |
|
3334 Lantern Way San Jose CA 95111-1317 | |
| (408) 202-1962 | |
| Not Available |
| Full Name | Urgent Doc Pro |
|---|---|
| Speciality | Clinic/Center |
| Location | 3334 Lantern Way, San Jose, California |
| Authorized Official Name and Position | Eileen V Moy (PRESIDENT) |
| Authorized Official Contact | 4082021962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urgent Doc Pro 3334 Lantern Way San Jose CA 95111-1317 Ph: (408) 202-1962 | Urgent Doc Pro 3334 Lantern Way San Jose CA 95111-1317 Ph: (408) 202-1962 |
| NPI Number | 1376167700 |
|---|---|
| Provider Enumeration Date | 06/01/2020 |
| Last Update Date | 04/05/2021 |
| Certification Date | 04/05/2021 |
| Medicare PECOS PAC ID | 6800208497 |
|---|---|
| Medicare Enrollment ID | O20210310002671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376167700 | NPI | - | NPPES |
| 1083617583 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Eileen V Moy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083617583 PECOS PAC ID: 0941248108 Enrollment ID: I20050419001223 |
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