1033296231 NPI number — SOUTHLAND ARTHRITES AND OSTEOPOROSIS MEDICAL CENTER INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033296231 NPI number — SOUTHLAND ARTHRITES AND OSTEOPOROSIS MEDICAL CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHLAND ARTHRITES AND OSTEOPOROSIS MEDICAL CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033296231
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
949 CALHOUN PL
Provider Second Line Business Mailing Address:
SUITE F
Provider Business Mailing Address City Name:
HEMET
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92543-4403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-652-5000
Provider Business Mailing Address Fax Number:
951-765-6688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29798 HAUN RD
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
MENIFEE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92586
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-672-1866
Provider Business Practice Location Address Fax Number:
951-672-1886
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MEHTA
Authorized Official First Name:
DENI
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
951-672-1866

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com