Organization
CORWIN URGENT CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWIT MAMO M.D. (CEO)
(760) 946-2957
Entity
Organization
Contact information
Practice address
16070 TUSCOLA ROAD, #101, APPLE VALLEY, CA 92307
(760) 242-4000
(760) 242-5250
Mailing address
PO BOX 3800, APPLE VALLEY, CA 92307-0074
(760) 242-4000
(760) 242-5250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A54482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0054490
—
CA
Enumeration date
03/16/2007
Last updated
10/09/2008
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