| San Jacinto Medical Clinic/ Urgi Care | |
|
1695 S San Jacinto Ave # A San Jacinto CA 92583 | |
| (951) 665-1100 | |
| Not Available |
| Full Name | San Jacinto Medical Clinic/ Urgi Care |
|---|---|
| Speciality | General Practice |
| Location | 1695 S San Jacinto Ave, San Jacinto, California |
| Authorized Official Name and Position | Vidhya Koka (OWNER) |
| Authorized Official Contact | 9516651100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Jacinto Medical Clinic/ Urgi Care 1695 S San Jacinto Ave Ste A San Jacinto CA 92583-5103 Ph: (951) 665-1100 | San Jacinto Medical Clinic/ Urgi Care 1695 S San Jacinto Ave # A San Jacinto CA 92583 Ph: (951) 665-1100 |
| NPI Number | 1801079892 |
|---|---|
| Provider Enumeration Date | 12/12/2007 |
| Last Update Date | 08/18/2008 |
| Medicare PECOS PAC ID | 1658450044 |
|---|---|
| Medicare Enrollment ID | O20080509000710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801079892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A55869 (California) | Secondary |
| 208000000X | Pediatrics | A60821 (California) | Secondary |
| 208D00000X | General Practice | A60821 (California) | Primary |
| Provider Name | Vidhyalakshmi Koka |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1740349372 PECOS PAC ID: 2365433646 Enrollment ID: I20040524001385 |
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