Provider Demographics
NPI:1902236169
Name:PATTERSON URGENT CARE INC
Entity Type:Organization
Organization Name:PATTERSON URGENT CARE INC
Other - Org Name:PATTERSON URGENT CARE AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SORIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-668-4101
Mailing Address - Street 1:PO BOX 2906
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95381-2906
Mailing Address - Country:US
Mailing Address - Phone:209-585-1066
Mailing Address - Fax:
Practice Address - Street 1:1010 SPERRY AVE STE D
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363
Practice Address - Country:US
Practice Address - Phone:209-892-3111
Practice Address - Fax:209-892-3112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI41641Medicare UPIN