| Urgent Care Center Of South Bay, Inc. | |
|
4305 Torrance Blvd Suite # 106 Torrance CA 90503-4409 | |
| (310) 542-9758 | |
| Not Available |
| Full Name | Urgent Care Center Of South Bay, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 4305 Torrance Blvd, Torrance, California |
| Authorized Official Name and Position | Peyam Vafadari (PRESIDENT) |
| Authorized Official Contact | 3107468260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urgent Care Center Of South Bay, Inc. 4305 Torrance Blvd Suite # 106 Torrance CA 90503-4409 Ph: (310) 542-9758 | Urgent Care Center Of South Bay, Inc. 4305 Torrance Blvd Suite # 106 Torrance CA 90503-4409 Ph: (310) 542-9758 |
| NPI Number | 1164547717 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7810088010 |
|---|---|
| Medicare Enrollment ID | O20070801000885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164547717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A065309 (California) | Primary |
| Provider Name | Casper T Glenn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649315508 PECOS PAC ID: 3375445224 Enrollment ID: I20040122000438 |
| Provider Name | Jonathan K Gottlieb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225380876 PECOS PAC ID: 1951626563 Enrollment ID: I20150202001273 |
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