Provider Demographics
NPI:1447641345
Name:L A URGENT CARE MEDICAL CENTER
Entity type:Organization
Organization Name:L A URGENT CARE MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMSHID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHARIATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-403-7809
Mailing Address - Street 1:401 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3620
Mailing Address - Country:US
Mailing Address - Phone:235-166-3613
Mailing Address - Fax:
Practice Address - Street 1:401 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3620
Practice Address - Country:US
Practice Address - Phone:235-166-3613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105315261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care