Black Rock Medical Care, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

545129 Issued in CA

Legal business name

BLACK ROCK MEDICAL CARE, INC.

Doing business as

Henry Mayo Urgent Care Center

Practice address

23929 McBean Pkwy Ste 102
Valencia, CA 91355-4467

Phone

(661) 200-2500

Fax

(661) 200-2504

NPI assigned

Aug 30, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tracy Norman Lawrence, MD

Title

Owner

Phone

(661) 200-2500

Specialties & licenses 1

Addresses

Other names 1

• Henry Mayo Urgent Care Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1205203882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23929 MCBEAN PKWY STE 102",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554467",
            "telephone_number": "661-200-2500",
            "fax_number": "661-200-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23929 MCBEAN PKWY STE 102",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554467",
            "telephone_number": "661-200-2500",
            "fax_number": "661-200-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK ROCK MEDICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-30",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-200-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "545129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Mayo Urgent Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry Mayo Urgent Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Nicole Bisharat
• Gloria Bishop, BCBA
• John G Bishop, DDS
• Tarek Bittar, MD
• Tiffany Marie Bitting, M.S.
• Barbara Blaisdell
• Luke Junho Blakely
• Asia Anna Marie Bland
• Bloom Marriage and Family Counseling Inc
• Paul Blount, LCSW

• Urgent Care Clinic/Center in Valencia, CA
• Providers in Valencia, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.