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General NPI Number Information
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NPI Number | 1902159460
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTHCARE OF TEMECULA
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 28910 RANCHO CALIFORNIA RD STE 102
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City | TEMECULA
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State | CA
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Zip | 92590-1868
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Country | US
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Telephone | 951-695-9183
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Fax | 951-676-6964
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Provider Business Mailing Address
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Address Line | 28910 RANCHO CALIFORNIA RD STE 102
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City | TEMECULA
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State | CA
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Zip | 92590-1868
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | AMANDA M NEWTON
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Credential |
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Telephone | 623-628-8654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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