Dyer's Urgent Care Medical Clinic

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

A80485 Issued in CA

Legal business name

DYER'S URGENT CARE MEDICAL CLINIC

Practice address

23961 Calle de la Magdalena
Suite 115
Laguna Hills, CA 92653-3616

Phone

(949) 206-4633

Fax

(949) 855-2314

NPI assigned

Aug 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brent W Ridder, M.D.NPI 1730120163

Title

Physician and Ownder

Phone

(949) 206-4633

Specialties & licenses 1

Addresses

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent Ridder, M.D.

  • Family Medicine Physician
  • Laguna Hills, CA
  • NPI 1730120163
  Authorized official Same address or phone

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356350896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA",
            "address_2": "SUITE 115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533616",
            "telephone_number": "949-206-4633",
            "fax_number": "949-855-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA",
            "address_2": "SUITE 115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533616",
            "telephone_number": "949-206-4633",
            "fax_number": "949-855-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYER'S URGENT CARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIDDER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN AND OWNDER",
        "authorized_official_telephone_number": "949-206-4633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "A80485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in Laguna Hills, CA
• Providers in Laguna Hills, 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 22, 2020; 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.