Healthcare Provider Details

I. General information

NPI: 1841143054
Provider Name (Legal Business Name): MENIFEE MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41715 WINCHESTER RD STE 107
TEMECULA CA
92590-4853
US

IV. Provider business mailing address

43460 RIDGE PARK DR STE 150
TEMECULA CA
92590-3755
US

V. Phone/Fax

Practice location:
  • Phone: 951-240-9105
  • Fax:
Mailing address:
  • Phone: 951-240-9105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SKYLER KING
Title or Position: CORPORATE SECRETARY
Credential: PA
Phone: 951-240-9105