Healthcare Provider Details

I. General information

NPI: 1841101912
Provider Name (Legal Business Name): THRIVE FAMILY HEALTH, A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28475 OLD TOWN FRONT ST STE N
TEMECULA CA
92590-1824
US

IV. Provider business mailing address

28475 OLD TOWN FRONT ST STE N
TEMECULA CA
92590-1824
US

V. Phone/Fax

Practice location:
  • Phone: 951-234-7651
  • Fax:
Mailing address:
  • Phone: 951-294-7359
  • 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. KELLY ELIZABETH BOYATT
Title or Position: CEO
Credential:
Phone: 951-294-7359