Healthcare Provider Details

I. General information

NPI: 1629216742
Provider Name (Legal Business Name): VIMI KAPUR M D ANESTH ESIOLOGIST INC A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 04/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25500 MEDICAL CENTER DR
MURRIETA CA
92562-5965
US

IV. Provider business mailing address

25470 MEDICAL CENTER DR SUITE 206
MURRIETA CA
92562-4900
US

V. Phone/Fax

Practice location:
  • Phone: 951-677-3010
  • Fax: 951-677-3168
Mailing address:
  • Phone: 951-677-3010
  • Fax: 951-677-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA105170
License Number StateCA

VIII. Authorized Official

Name: DR. VIMI KAPUR
Title or Position: PRESIDENT
Credential: MD
Phone: 951-677-3010