Organization
YACOUB MEDICAL, INC.
Active
Other names
Doctors Urgent Care Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER P YACOUB (OFFICE MANAGER)
(323) 720-9204
Entity
Organization
Contact information
Practice address
120 S MONTEBELLO BLVD, MONTEBELLO, CA 90640-4730
(323) 720-9204
(323) 720-9208
Mailing address
120 S MONTEBELLO BLVD, MONTEBELLO, CA 90640-4730
(323) 720-9204
(323) 720-9208
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0680379
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0070010
—
CA
Enumeration date
01/29/2008
Last updated
11/06/2008
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