Healthcare Provider Details

I. General information

NPI: 1003617499
Provider Name (Legal Business Name): AGM MEDICAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27349 JEFFERSON AVE STE 213
TEMECULA CA
92590-5632
US

IV. Provider business mailing address

27349 JEFFERSON AVE STE 213
TEMECULA CA
92590-5632
US

V. Phone/Fax

Practice location:
  • Phone: 858-229-4949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW DESJARDINS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 858-229-4949