Provider Demographics
NPI:1063928463
Name:PRIORITY URGENT CARE
Entity type:Organization
Organization Name:PRIORITY URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:LOEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-556-4777
Mailing Address - Street 1:4821 PANAMA LN # A-C
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-3480
Mailing Address - Country:US
Mailing Address - Phone:661-556-4777
Mailing Address - Fax:661-556-4782
Practice Address - Street 1:611 AIRPORT DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-4127
Practice Address - Country:US
Practice Address - Phone:661-556-4777
Practice Address - Fax:661-556-4782
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIORITY URGENT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty