Healthcare Provider Details

I. General information

NPI: 1750562906
Provider Name (Legal Business Name): JAIMER GALVEZ CADANG PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43500 RIDGE PARK DR
TEMECULA CA
92590-3624
US

IV. Provider business mailing address

44640 WOLTNER CT
TEMECULA CA
92592-5679
US

V. Phone/Fax

Practice location:
  • Phone: 951-308-2200
  • Fax:
Mailing address:
  • Phone: 858-500-2873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number58766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: