Healthcare Provider Details

I. General information

NPI: 1477606424
Provider Name (Legal Business Name): HEMET EKG INTERPRETATION MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 E DEVONSHIRE AVE CARDIOLOGY OFFICE
HEMET CA
92543-3083
US

IV. Provider business mailing address

324 S STATE ST UNIT 1230
HEMET CA
92546-7051
US

V. Phone/Fax

Practice location:
  • Phone: 951-652-2811
  • Fax:
Mailing address:
  • Phone: 951-658-8505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J WELCH
Title or Position: CHIEF OPERATING OFFICER
Credential: PH.D.
Phone: 951-658-8505