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General NPI Number Information
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NPI Number | 1114742798
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Entity Type | Organization
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Legal Business Name | RANCHO FAMILY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 25460 MEDICAL CENTER DR STE 100
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City | MURRIETA
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State | CA
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Zip | 92562-5985
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Country | US
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Telephone | 951-677-4748
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Fax |
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Provider Business Mailing Address
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Address Line | 41923 2ND ST STE 204
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City | TEMECULA
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State | CA
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Zip | 92590-2833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | R. ERIC MADRID
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Credential |
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Telephone | 951-676-4193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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