| Malibu Canyon Urgent Care Llc | |
|
5673 Las Virgenes Rd Calabasas CA 91302-1069 | |
| (818) 919-4175 | |
| Not Available |
| Full Name | Malibu Canyon Urgent Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5673 Las Virgenes Rd, Calabasas, California |
| Authorized Official Name and Position | Salvador Plasencia (OWNER) |
| Authorized Official Contact | 8189194175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Malibu Canyon Urgent Care Llc 5673 Las Virgenes Rd Calabasas CA 91302-1069 Ph: (818) 919-4175 | Malibu Canyon Urgent Care Llc 5673 Las Virgenes Rd Calabasas CA 91302-1069 Ph: (818) 919-4175 |
| NPI Number | 1356931760 |
|---|---|
| Provider Enumeration Date | 01/20/2021 |
| Last Update Date | 07/01/2022 |
| Medicare PECOS PAC ID | 6305229915 |
|---|---|
| Medicare Enrollment ID | O20220815002261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356931760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Nadia S Trochanova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265858146 PECOS PAC ID: 5991083511 Enrollment ID: I20161101001835 |
| Provider Name | Salvador Plasencia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881953156 PECOS PAC ID: 1850523374 Enrollment ID: I20170609001691 |
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