| Executive Urgent Care Centers Inc | |
|
74785 Hwy 111, Suite 100 Indian Wells CA 92210 | |
| (760) 346-3939 | |
| Not Available |
| Full Name | Executive Urgent Care Centers Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 74785 Hwy 111, Suite 100, Indian Wells, California |
| Authorized Official Name and Position | Pedram Ilbeigi (CEO) |
| Authorized Official Contact | 9732719183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Urgent Care Centers Inc 18400 Us Highway 18 Ste A Apple Valley CA 92307-2306 Ph: (760) 242-3939 | Executive Urgent Care Centers Inc 74785 Hwy 111, Suite 100 Indian Wells CA 92210 Ph: (760) 346-3939 |
| NPI Number | 1124796362 |
|---|---|
| Provider Enumeration Date | 09/02/2021 |
| Last Update Date | 09/02/2021 |
| Medicare PECOS PAC ID | 8628454824 |
|---|---|
| Medicare Enrollment ID | O20220926000694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124796362 | NPI | - | NPPES |
| Provider Name | Herman R Mcdaniel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063524130 PECOS PAC ID: 9335185180 Enrollment ID: I20050630001170 |
| Provider Name | Bohdan T Olesnicky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043254709 PECOS PAC ID: 1153490933 Enrollment ID: I20080520000347 |
| Provider Name | Glenn Arthur Cooperman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679821979 PECOS PAC ID: 7214176403 Enrollment ID: I20130619000361 |
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