Provider Demographics
NPI:1043081821
Name:4KIDS URGENT CARE MEDICAL CENTER, INC
Entity type:Organization
Organization Name:4KIDS URGENT CARE MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOU
Authorized Official - Middle Name:CHOUA
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-990-9219
Mailing Address - Street 1:3727 N 1ST
Mailing Address - Street 2:STE 106
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-5628
Mailing Address - Country:US
Mailing Address - Phone:559-890-6111
Mailing Address - Fax:559-892-0327
Practice Address - Street 1:3727 N 1ST
Practice Address - Street 2:STE 106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-5628
Practice Address - Country:US
Practice Address - Phone:559-890-6111
Practice Address - Fax:559-892-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty