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General NPI Number Information
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NPI Number | 1801278718
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Entity Type | Organization
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Legal Business Name | TEMECULA VALLEY CARDIOLOGY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 06/26/2015
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 31565 RANCHO PUEBLO RD 200
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City | TEMECULA
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State | CA
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Zip | 92592-4838
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Country | US
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Telephone | 951-698-4600
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Fax | 951-514-2542
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Provider Business Mailing Address
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Address Line | 25470 MEDICAL CENTER DR STE 105
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City | MURRIETA
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State | CA
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Zip | 92562-4901
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Country | US
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Telephone | 951-698-4600
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Fax | 951-514-2542
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LESLIE SHAEFFER
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Credential |
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Telephone | 951-698-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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