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General NPI Number Information
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NPI Number | 1356431233
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Entity Type | Organization
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Legal Business Name | RANCHO VALLEY ORTHOPAEDIC SURGERY MEDICAL CLINIC INC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 29373 RANCHO CALIF RD
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City | TEMECULA
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State | CA
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Zip | 92591-5201
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Country | US
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Telephone | 951-699-4472
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Fax | 951-694-8424
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Provider Business Mailing Address
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Address Line | 29373 RANCHO CALIF RD
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City | TEMECULA
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State | CA
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Zip | 92591-5201
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Country | US
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Telephone | 951-699-4472
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Fax | 951-694-8424
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW C KIM
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Credential | MD
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Telephone | 951-699-4472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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