Healthcare Provider Details

I. General information

NPI: 1598791600
Provider Name (Legal Business Name): RANCHO FAMILY MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28780 SINGLE OAK DR STE 160
TEMECULA CA
92590-3625
US

IV. Provider business mailing address

28780 SINGLE OAK DR STE 160
TEMECULA CA
92590-3625
US

V. Phone/Fax

Practice location:
  • Phone: 951-676-4193
  • Fax: 951-719-1469
Mailing address:
  • Phone: 951-676-4193
  • Fax: 951-719-1469

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: DENISE CAIN
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 951-676-4193