EVERGREEN URGENT CARE INC NPI 1487048963

NPI Information

NPI: 1487048963
Provider Name: EVERGREEN URGENT CARE INC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 05D2100866

Address:
2365 QUIMBY ROAD
SUITE 160
SAN JOSE, CA
ZIP 95122
Phone: (408) 258-5083
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EVERGREEN URGENT CARE INC is an urgent care clinic center in San Jose, CA. EVERGREEN URGENT CARE INC NPI is 1487048963. The provider is registered as an organization entity type.

The provider's business location address is:

2365 QUIMBY ROAD
SUITE 160
SAN JOSE, CA
ZIP 95122-337
Phone: (408) 258-5083
Fax: (408) 258-4347

The provider's authorized official is Tam Hoang Ngnyen .
The authorized official title is Ceo/physician and has the following contact phone number (408) 258-5083.

The CLIA number assigned to this NPI record is 05D2100866 - other - urgent care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/24/2015 and was last updated on 10/22/2015.

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	261QU0200X	Clinic/Center	Urgent Care			Yes

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

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