Healthcare Provider Details

I. General information

NPI: 1326608480
Provider Name (Legal Business Name): SOLEIMANI MEDICAL GROUP A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32827 TEMECULA PKWY
TEMECULA CA
92592-7313
US

IV. Provider business mailing address

32827 TEMECULA PKWY
TEMECULA CA
92592-7313
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-9595
  • Fax:
Mailing address:
  • Phone: 951-358-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MEHRDAD SOLEIMANI
Title or Position: PRESIDENT
Credential: MD
Phone: 951-358-9595