URDC HUMAN SERVICES CORPORATION NPI 1114963642

NPI Information

NPI: 1114963642
Provider Name: URDC HUMAN SERVICES CORPORATION

Doing Business As: BILL MOORE COMMUNITY HEALTH CLINIC

Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

Address:
1460 N LAKE AVE
PASADENA, CA
ZIP 91104
Phone: (626) 398-3796
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URDC HUMAN SERVICES CORPORATION is a community health clinic center in Pasadena, CA. URDC HUMAN SERVICES CORPORATION NPI is 1114963642. The provider is registered as an organization entity type.
The provider Is Doing Business As Bill Moore Community Health Clinic.

The provider's business location address is:

1460 N LAKE AVE
PASADENA, CA
ZIP 91104-300
Phone: (626) 398-3796
Fax: (626) 398-3895

The provider's authorized official is Al Sorkin .
The authorized official title is Executive Director and has the following contact phone number (626) 398-3796.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QC1500X	Clinic/Center	Community Health	CMM70645F	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CMM70645F	MEDICAID	CALIFORNIA
2	W16126	OTHER		PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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