=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831332840
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TEMPS, THE MEDICAL PRO, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2009
-----------------------------------------------------
Last Update Date | 04/07/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 32332 CAMINO CAPISTRANO STE 205
-----------------------------------------------------
City | SAN JUAN CAPISTRANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92675-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-545-6646
-----------------------------------------------------
Fax | 949-545-6866
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32332 CAMINO CAPISTRANO STE 205
-----------------------------------------------------
City | SAN JUAN CAPISTRANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92675-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-545-6646
-----------------------------------------------------
Fax | 949-545-6866
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MARTIN A CANALES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 949-545-6646
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------