Main Street Urgent Care, Inc. | |
1040 N Main St Manteca CA 95336-3745 | |
(209) 825-5155 | |
(209) 825-6155 |
Full Name | Main Street Urgent Care, Inc. |
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Speciality | Clinic/Center |
Location | 1040 N Main St, Manteca, California |
Authorized Official Name and Position | Jana Marie Anslinger (OFFICE SUPERVISOR) |
Authorized Official Contact | 2098255155 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Main Street Urgent Care, Inc. Po Box 969 Woodbridge CA 95258-0969 Ph: (209) 825-5155 | Main Street Urgent Care, Inc. 1040 N Main St Manteca CA 95336-3745 Ph: (209) 825-5155 |
NPI Number | 1760403125 |
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Provider Enumeration Date | 07/21/2006 |
Last Update Date | 11/03/2011 |
Medicare PECOS PAC ID | 2769422443 |
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Medicare Enrollment ID | O20050712000654 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760403125 | NPI | - | NPPES |
05D1045635 | Other | CA | CLIA |
GR0100060 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | A54317 (California) | Primary |
Provider Name | Rajesh Kumar Maheshwari |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740431246 PECOS PAC ID: 7911143383 Enrollment ID: I20160212000943 |
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