Organization
PREMIUM URGENT CARE, INC.
Active
Other names
Premium Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERICK J GREEN M.D. (OWNER)
(559) 797-4315
Entity
Organization
Contact information
Practice address
1415 BADGER FLAT RD, SUITE A, LOS BANOS, CA 93635-8600
(209) 826-8400
(209) 710-8763
Mailing address
2021 HERNDON AVE, SUITE 101, CLOVIS, CA 93611-6101
(559) 797-4315
(559) 321-8730
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109622
PREMIUM URGENT CARE GROUP PTAN
CA
Enumeration date
10/07/2015
Last updated
05/02/2019
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