NELLIE GAIL URGENT CARE MEDICAL CORP
NPI 1073909859
Clinic/Center - Urgent Care in Laguna Hills, CA

Active since April 08, 2015CLIA Certified · 2 labs
27001 MOULTON PKWY, SUITE A-102, LAGUNA HILLS, CA 92656(949) 600-1907(949) 600-1912 Get Directions Write a Review

NPPES record last updated: September 22, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nellie Gail Urgent Care Medical Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NELLIE GAIL URGENT CARE MEDICAL CORP (NPI 1073909859) is a healthcare organization registered as an urgent care in Laguna Hills, California and active in the NPI registry since April 2015. The organization holds 2 active CLIA laboratory certificates and lists Jack Bailey Vu, Physician, as its authorized official.

NPPES Registry Identity

NPI1073909859
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameNELLIE GAIL URGENT CARE MEDICAL CORP
Location Address27001 MOULTON PKWY, SUITE A-102Laguna Hills, CA 92656-3626
Mailing Address27001 Moulton Pkwy, Suite A-102Laguna Hills, CA 92656-3626 · (949) 600-1907 · Fax (949) 600-1912
Fax(949) 600-1912
Organization SubpartNo
Authorized OfficialJack Bailey VuPhysician · (949) 600-1907
Enumeration DateApril 8, 2015
Last NPPES UpdateSeptember 22, 2015
✔ NPI 1073909859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
License✔ Licensed in CA · FNP544683
Also ListedFamily MedicineTaxonomy 207Q00000X
27001 MOULTON PKWY, Laguna Hills, CA 92656

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nellie Gail Urgent Care Medical Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Nellie Gail Urgent Care Medical Corp, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Family Practice
NPI 1467640888
4870 BARRANCA PKWY 110
Irvine, CA 92604
(949) 857-1248
✔ PECOS✔ Accepts Medicare9.1 mi
Nurse Practitioner
NPI 1902381155
18785 BROOKHURST ST
Fountain Valley, CA 92708
(714) 378-0042
✔ PECOS17 mi
Nurse Practitioner
NPI 1023596400
1679 E MONTE VISTA AVE STE 104
Vacaville, CA 95688
(707) 624-7400
✔ PECOS✔ Accepts Medicare408 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2170908

Nellie Gail Urgent Care · Orange, CA
Active · expires Dec 1, 2027
CLIA Number05D2170908
Laboratory TypePhysician Office
Certificate Effective DateDecember 2, 2025
Certificate Expiration DateDecember 1, 2027
Laboratory DirectorMehrdad Salimkhanian
Laboratory Phone(949) 600-1907
Laboratory LocationNellie Gail Urgent Care315 South Tustin St, Orange, CA 92866
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2096172

Nellie Gail Urgent Care · Aliso Viejo, CA
Active · expires May 17, 2027
CLIA Number05D2096172
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateMay 18, 2025
Certificate Expiration DateMay 17, 2027
Laboratory DirectorMehrdad Salimkhanian
Laboratory Phone(949) 600-1907
Laboratory LocationNellie Gail Urgent Care27001 Moulton Pkwy Ste A-102, Aliso Viejo, CA 92656
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nellie Gail Urgent Care Medical Corp's NPI number?

The NPI number for Nellie Gail Urgent Care Medical Corp is 1073909859. It was assigned to this organization in the NPPES registry on April 8, 2015.

Where is Nellie Gail Urgent Care Medical Corp located?

Nellie Gail Urgent Care Medical Corp is located at 27001 Moulton Pkwy Suite A-102, Laguna Hills, CA 92656. The listed phone number is (949) 600-1907.

What is Nellie Gail Urgent Care Medical Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Is Nellie Gail Urgent Care Medical Corp enrolled in Medicare?

Yes. Nellie Gail Urgent Care Medical Corp is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Nellie Gail Urgent Care Medical Corp?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Nellie Gail Urgent Care Medical Corp, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Nellie Gail Urgent Care Medical Corp hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Nellie Gail Urgent Care Medical Corp was last updated on September 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.