Healthcare Provider Details

I. General information

NPI: 1740650365
Provider Name (Legal Business Name): TEMECULA CENTER FOR CARDIAC CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31565 RANCHO PUEBLO RD STE 201
TEMECULA CA
92592-4839
US

IV. Provider business mailing address

31565 RANCHO PUEBLO RD STE. 201
TEMECULA CA
92592-4838
US

V. Phone/Fax

Practice location:
  • Phone: 951-225-7800
  • Fax: 951-225-7818
Mailing address:
  • Phone: 951-225-7800
  • Fax: 951-225-7818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW TUAN HO
Title or Position: PARTNER
Credential: MD, FACC
Phone: 951-225-7800