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Organization

AVALON URGENT CARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RUI ANTHONY DA SILVA MD (PRESIDENT)
(760) 365-0851
Entity
Organization

Contact information

Practice address
58471 29 PALMS HWY, SUITE 303, YUCCA VALLEY, CA 92284-5818
(760) 365-0851
(760) 365-6848
Mailing address
58471 29 PALMS HWY, SUITE 303, YUCCA VALLEY, CA 92284-5818
(760) 365-0851
(760) 365-6848

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A89717
CA
207R00000X
Internal Medicine Physician
G36975
CA
208D00000X
General Practice Physician
A33298
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A332980
CA
05
00A897170
CA
05
00G369750
CA
01
A332980
LIC
CA
01
ZZZ11547Z
MEDICARE ID
CA
Enumeration date
08/23/2006
Last updated
08/19/2009
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