Active NPI
Executive Urgent Care Centers Inc
- Urgent Care Clinic/Center
- Indian Wells, CA
National Provider Identifier
1124796362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- EXECUTIVE URGENT CARE CENTERS INC
- Practice address
- 74785 Hwy 111, Suite 100
Indian Wells, CA 92210 - Phone
- (760) 346-3939
- NPI assigned
- Sep 2, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bohdan Olesnicky, MD
- Title
- Ceo
- Phone
- (760) 464-2131
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Primary |
Addresses
Primary practice location
74785 Hwy 111, Suite 100
Indian Wells, CA 92210
Mailing address
74785 Hwy 111, Ste 100
Indian Wells, CA 92210
Phone (760) 346-3932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
74785 US Highway 111
Ste 100
Indian Wells, CA 92210
Phone (760) 346-3932
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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- NPI 1063524130
CA, Single Specialty
-
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- NPI 1629099080
-
- Chiropractor
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630540800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745280000000",
"number": "1124796362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74785 HWY 111, STE 100",
"city": "INDIAN WELLS",
"state": "CA",
"postal_code": "92210",
"telephone_number": "760-346-3932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74785 HWY 111, SUITE 100",
"city": "INDIAN WELLS",
"state": "CA",
"postal_code": "92210",
"telephone_number": "760-346-3939"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXECUTIVE URGENT CARE CENTERS INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-02",
"last_updated": "2025-04-22",
"certification_date": "2025-04-14",
"status": "A",
"authorized_official_last_name": "OLESNICKY",
"authorized_official_first_name": "BOHDAN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "760-464-2131",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indian Wells, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.