Healthcare Provider Details

I. General information

NPI: 1922897263
Provider Name (Legal Business Name): OPS212, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 05/03/2025
Certification Date: 05/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27367 ELK HILL DR
MENIFEE CA
92586-5228
US

IV. Provider business mailing address

41593 WINCHESTER RD STE 200
TEMECULA CA
92590-4857
US

V. Phone/Fax

Practice location:
  • Phone: 951-740-2681
  • Fax:
Mailing address:
  • Phone: 951-740-2681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: NOEL ALICEACINTRON
Title or Position: PRESIDENT
Credential:
Phone: 951-740-2681