Organization Active NPI

Simi Valley Urgent Care Inc

  • Urgent Care Clinic/Center
  • Simi Valley, CA
National Provider Identifier
1477376028
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SIMI VALLEY URGENT CARE INC
Practice address
1350 E Los Angeles Ave Ste 100
Simi Valley, CA 93065-2898
Phone
(805) 272-6590
Fax
(805) 272-6591
NPI assigned
Nov 4, 2024
Last updated
Feb 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Farah Sultana Hasan, MDNPI 1568581726
Title
Authorized Official
Phone
(805) 272-6590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

1350 E Los Angeles Ave Ste 100
Simi Valley, CA 93065-2898

Mailing address

1350 E Los Angeles Ave Ste 100
Simi Valley, CA 93065-2898
Phone (818) 854-0759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250128001112 CA Part B Supplier - Clinic/Group Practice 9032648613 Receives reassigned benefits from 1 practitioner
Practice locations: Simi Valley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2318933Simi Valley Urgent Care Inc1350 East Los Angeles Avenue, Simi Valley, CA 93065Certificate of waiverFeb 19, 2027

National Provider Directory

National Provider Directory

Locations

1350 E Los Angeles Ave
Ste 100
Simi Valley, CA 93065
Phone (805) 272-6590

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1477376028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E LOS ANGELES AVE STE 100",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652898",
            "telephone_number": "818-854-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E LOS ANGELES AVE STE 100",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652898",
            "telephone_number": "805-272-6590",
            "fax_number": "805-272-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMI VALLEY URGENT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "HASAN",
        "authorized_official_first_name": "FARAH",
        "authorized_official_middle_name": "SULTANA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "805-272-6590",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.