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Organization
NELLIE GAIL URGENT CARE MEDICAL CORP
Active
Organization
NELLIE GAIL URGENT CARE MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK BAILEY VU M.D. (PHYSICIAN)
(949) 600-1907
Entity
Organization
Contact information
Practice address
27001 MOULTON PKWY, SUITE A-102, LAGUNA HILLS, CA 92656-3626
(949) 600-1907
(949) 600-1912
Mailing address
27001 MOULTON PKWY, SUITE A-102, LAGUNA HILLS, CA 92656-3626
(949) 600-1907
(949) 600-1912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
FNP544683
CA
Other
Enumeration date
04/08/2015
Last updated
09/22/2015
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