1982279329 NPI number — UNIVERSAL HEALTH NET INLAND EMPIRE

Table of content: (NPI 1982279329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982279329 NPI number — UNIVERSAL HEALTH NET INLAND EMPIRE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSAL HEALTH NET INLAND EMPIRE
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:
1982279329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 HOLLYLEAF
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALISO VIEJO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92656-2130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-690-5224
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 E KIMBALL AVE STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEMET
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92543-4254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-690-5224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ABUSAFIEH
Authorized Official First Name:
AMENHEH
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/OWNER
Authorized Official Telephone Number:
949-690-5224

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com