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Organization

SAN JUAN FAMILY HEALTH URGENT CARE MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SHAHROKH POORMEHR D.O. (D.O., PRESIDENT)
(949) 248-9797
Entity
Organization

Contact information

Practice address
32112 CAMINO CAPISTRANO, SAN JUAN CAPISTRANO, CA 92675-3717
(949) 248-9797
(949) 388-3336
Mailing address
32112 CAMINO CAPISTRANO, SAN JUAN CAPISTRANO, CA 92675-3717
(949) 248-9797
(949) 388-3336

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A6385
CA
261Q00000X
Clinic/Center
20A6385
CA
261QU0200X
Urgent Care Clinic/Center
Primary
20A6385
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX63850
CA
01
20A6385
STATE LICENSE
CA
01
DC5333
RAILROAD MEDICARE
CA
01
ZZZ57256Z
BLUE SHIELD
CA
Enumeration date
08/25/2007
Last updated
03/11/2015
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