AGILE OCCUPATIONAL MEDICINE LLCPC NPI 1558051995

NPI Information

NPI: 1558051995
Provider Name: AGILE OCCUPATIONAL MEDICINE, LLCPC
Classification: Clinic/Center - 261QX0100X
Entity Type: Organization

Specialization: Occupational Medicine

CLIA Number: 05D2299090

Address:
285 MERCEY SPRINGS RD STE A
LOS BANOS, CA
ZIP 93635
Phone: (209) 829-0444
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AGILE OCCUPATIONAL MEDICINE, LLCPC is an occupational medicine clinic center in Los Banos, CA. AGILE OCCUPATIONAL MEDICINE, LLCPC NPI is 1558051995. The provider is registered as an organization entity type.

The provider's business location address is:

285 MERCEY SPRINGS RD STE A
LOS BANOS, CA
ZIP 93635-878
Phone: (209) 829-0444

The provider's authorized official is Gregory Moore .
The authorized official title is Ceo and has the following contact phone number (844) 207-8321.

The CLIA number assigned to this NPI record is 05D2299090 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2023 and was last updated on 1/2/2024.

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	261QX0100X	Clinic/Center	Occupational Medicine			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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