STATELY URGENT CARE PC – NPI #1104757145
Clinic/Center

STATELY URGENT CARE PC is an AHC clinic located in REDLANDS, CA. NPPES recently assigned the NPI number 1104757145 to STATELY URGENT CARE PC on May 28, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QU0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Urgent Care

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for STATELY URGENT CARE PC below.

NPI Profile for
STATELY URGENT CARE PC

NPI Number
1104757145
Enumeration Date

(about a week ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STATELY URGENT CARE PC
Primary location
1467 FORD ST STE 201
REDLANDS, CA 92373-3912
Phone: (909) 712-0414 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SALMA GREEN
PHYSICIAN/CEO/OWNER
Phone: (909) 712-0414
Updated
Certification Date
May 28, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QU0200X
- Clinic/Center / Urgent Care (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.