Healthcare Provider Details

I. General information

NPI: 1376692988
Provider Name (Legal Business Name): CORONA FAMILY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 S MAIN ST STE 210
CORONA CA
92882-2533
US

IV. Provider business mailing address

341 MAGNOLIA AVE STE 201
CORONA CA
92879-3332
US

V. Phone/Fax

Practice location:
  • Phone: 951-735-9211
  • Fax: 951-735-6200
Mailing address:
  • Phone: 951-735-9211
  • Fax: 951-735-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. JEFFERY ALAN MULLER
Title or Position: OWNER
Credential: M.D.
Phone: 951-735-9211