Organization
YACOUB MEDICAL INC.
Active
Parent organization
MEDVANTX, INC.
Other names
Doctors Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
120 S MONTEBELLO BLVD, MONTEBELLO, CA 90640-4730
(323) 726-0577
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A40189
CA
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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