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General NPI Number Information
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NPI Number | 1205084449
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Entity Type | Organization
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Legal Business Name | TOTAL CARE FAMILY MEDICAL CENTER OF LAKE ELSINORE INC.
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Dates
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Enumeration Date | 08/29/2008
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 24703 MONROE AVE
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City | MURRIETA
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State | CA
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Zip | 92562-9569
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Country | US
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Telephone | 951-698-1168
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Fax | 951-698-0768
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Provider Business Mailing Address
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Address Line | 24703 MONROE AVE
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City | MURRIETA
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State | CA
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Zip | 92562-9569
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Country | US
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Telephone | 951-698-1168
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Fax | 951-698-0768
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Authorized Official
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Title or Position | OWNER/OFFICER
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Name | DR. NA'IMAH D POWELL
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Credential | M.D.
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Telephone | 951-698-1168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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