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General NPI Number Information
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NPI Number | 1720306368
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Entity Type | Organization
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Legal Business Name | HEMET HEALTHCARE MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 1275 E LATHAM AVE STE C
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City | HEMET
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State | CA
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Zip | 92543-4424
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Country | US
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Telephone | 951-652-5132
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 E LATHAM AVE STE C
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City | HEMET
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State | CA
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Zip | 92543-4424
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Country | US
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Telephone | 951-652-5132
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANIL RASTOGI
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Credential | MD
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Telephone | 951-652-5132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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