Healthcare Provider Details

I. General information

NPI: 1023436599
Provider Name (Legal Business Name): PREMISE HEALTH OF CALIFORNIA MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3984 INDIANA AVE
PERRIS CA
92571-3154
US

IV. Provider business mailing address

5500 MARYLAND WAY
BRENTWOOD TN
37027-7048
US

V. Phone/Fax

Practice location:
  • Phone: 951-443-2543
  • Fax: 951-443-2556
Mailing address:
  • Phone: 951-443-2543
  • Fax: 951-443-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN LEIZMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 216-479-9063