| Avalon Urgent Care Inc | |
|
58471 29 Palms Hwy Suite 303 Yucca Valley CA 92284-5818 | |
| (760) 365-0851 | |
| (760) 365-6848 |
| Full Name | Avalon Urgent Care Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 58471 29 Palms Hwy, Yucca Valley, California |
| Authorized Official Name and Position | Rui Anthony Da Silva (PRESIDENT) |
| Authorized Official Contact | 7603650851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avalon Urgent Care Inc 58471 29 Palms Hwy Suite 303 Yucca Valley CA 92284-5818 Ph: (760) 365-0851 | Avalon Urgent Care Inc 58471 29 Palms Hwy Suite 303 Yucca Valley CA 92284-5818 Ph: (760) 365-0851 |
| NPI Number | 1760599237 |
|---|---|
| Provider Enumeration Date | 08/23/2006 |
| Last Update Date | 08/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760599237 | NPI | - | NPPES |
| 00G369750 | Medicaid | CA | |
| 00A332980 | Medicaid | CA | |
| 00A897170 | Medicaid | CA | |
| A332980 | Other | CA | LIC |
| ZZZ11547Z | Other | CA | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A89717 (California) | Primary |
| 207R00000X | Internal Medicine | G36975 (California) | Secondary |
| 208D00000X | General Practice | A33298 (California) | Secondary |
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