NPIMap

Organization Active NPI

GK Urgi Care Inc

  • General Practice Physician
  • San Jacinto, CA
National Provider Identifier
1801079892
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A60821 Issued in CA
Legal business name
GK URGI CARE INC
Practice address
1695 S San Jacinto Ave
# A
San Jacinto, CA 92583
Phone
(951) 665-1100
NPI assigned
Dec 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
Vidhya Koka, M.D.
Title
Owner
Phone
(951) 665-1100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A55869 CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A60821 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A60821 CA Primary

Addresses

Primary practice location

1695 S San Jacinto Ave
# A
San Jacinto, CA 92583

Mailing address

1695 S San Jacinto Ave Ste a
San Jacinto, CA 92583-5103
Phone (951) 665-1100

Other names 1

  • SAN JACINTO MEDICAL CLINIC/ URGI CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080509000710 CA Part B Supplier - Clinic/Group Practice 1658450044 Receives reassigned benefits from 1 practitioner
Practice locations: Hemet, CA

National Provider Directory

National Provider Directory
Tax ID family
GK Urgi Care Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

424 N San Jacinto St
Hemet, CA 92543

1579 S San Jacinto Ave
San Jacinto, CA 92583
Phone (909) 665-1100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1801079892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 S SAN JACINTO AVE STE A",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925835103",
            "telephone_number": "951-665-1100",
            "fax_number": "951-665-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 S SAN JACINTO AVE",
            "address_2": "# A",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "92583",
            "telephone_number": "951-665-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GK URGI CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "KOKA",
        "authorized_official_first_name": "VIDHYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-665-1100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55869",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A60821",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A60821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN JACINTO MEDICAL CLINIC/ URGI CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.

Verify at the official NPI Registry.