Organization
NORCAL URGENT CARE, INC
Active
Other names
Main Street Urgent Care, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANA MARIE ANSLINGER (OFFICE SUPERVISOR)
(209) 825-5155
Entity
Organization
Contact information
Practice address
1040 N MAIN ST, MANTECA, CA 95336-3745
(209) 825-5155
(209) 825-6155
Mailing address
PO BOX 969, WOODBRIDGE, CA 95258-0969
(209) 825-5155
(209) 825-6155
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A54317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1045635
CLIA
CA
05
—
GR0100060
—
CA
Enumeration date
07/21/2006
Last updated
11/03/2011
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