1952609760 NPI number — PHYSICIANS' HOSPITAL OF MURRIETA, LLC

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 1952609760 NPI number — PHYSICIANS' HOSPITAL OF MURRIETA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICIANS' HOSPITAL OF MURRIETA, LLC
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:
6
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:
1952609760
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28062 BAXTER ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURRIETA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-290-4130
Provider Business Mailing Address Fax Number:
951-290-4953

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28078 BAXTER ROAD
Provider Second Line Business Practice Location Address:
SUITE 326
Provider Business Practice Location Address City Name:
MURRIETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-290-4130
Provider Business Practice Location Address Fax Number:
951-290-4953
Provider Enumeration Date:
03/02/2011

Additional Information

Authorized Official

Authorized Official Last Name:
LOOP
Authorized Official First Name:
DOUG
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
951-704-1934

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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