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General NPI Number Information
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NPI Number | 1417050071
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Entity Type | Organization
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Legal Business Name | TEMECULA VALLEY NUCLEAR MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 25485 MEDICAL CENTER DR SUITE 102
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City | MURRIETA
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State | CA
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Zip | 92562-6900
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Country | US
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Telephone | 951-698-4808
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Fax | 951-698-4805
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Provider Business Mailing Address
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Address Line | 25485 MEDICAL CENTER DRIVE SUITE 102
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City | MURRIETA
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State | CA
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Zip | 92562
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Country | US
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Telephone | 951-698-4808
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Fax | 951-698-4805
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. ERNIE G METH
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Credential | M.D.
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Telephone | 951-698-4808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0903X
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Taxonomy Name | In Vivo & In Vitro Nuclear Medicine Physician
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License Number | A41717
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License Number State | CA
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