Organization
PROSPECT FOOTHILL URGENT CARE
Active
Parent organization
NEW GENESIS MEDICAL ASSOCIATES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW GENESIS MEDICAL ASSOCIATES, INC.
Authorized official
MITCHELL W LEW MD (OWNER)
(714) 813-5129
Entity
Organization
Contact information
Practice address
14642 NEWPORT AVE STE 101, TUSTIN, CA 92780-6058
(714) 522-2891
Mailing address
PO BOX 11466, SANTA ANA, CA 92711-1466
(714) 522-2891
(714) 903-7801
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/23/2015
Last updated
03/26/2015
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