Healthcare Provider Details

I. General information

NPI: 1730178278
Provider Name (Legal Business Name): WAYNE CRAIG GARRETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date: 10/18/2005
Reactivation Date: 10/19/2005

III. Provider practice location address

25500 MEDICAL CENTER DR
MURRIETA CA
92562-5965
US

IV. Provider business mailing address

3156 VISTA WAY SUITE 405
OCEANSIDE CA
92056-3622
US

V. Phone/Fax

Practice location:
  • Phone: 909-696-6000
  • Fax:
Mailing address:
  • Phone: 760-439-6581
  • Fax: 760-439-6585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA64587
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA64587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: