Healthcare Provider Details

I. General information

NPI: 1891436630
Provider Name (Legal Business Name): GEORGE BARBOZA FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39755 MURRIETA HOT SPRINGS RD STE E120
MURRIETA CA
92563-9115
US

IV. Provider business mailing address

1545 W FLORIDA AVE
HEMET CA
92543-3814
US

V. Phone/Fax

Practice location:
  • Phone: 951-461-1331
  • Fax: 888-696-2614
Mailing address:
  • Phone: 951-791-1111
  • Fax: 888-856-3893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95020563
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: