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General NPI Number Information
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NPI Number | 1962390583
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Entity Type | Organization
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Legal Business Name | INNOVATIVE MEDICAL SPECIALTIES INC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 44045 MARGARITA RD STE 101
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City | TEMECULA
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State | CA
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Zip | 92592-2729
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Country | US
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Telephone | 951-880-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 44045 MARGARITA RD STE 101
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City | TEMECULA
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State | CA
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Zip | 92592-2729
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Country | US
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Telephone | 951-880-0701
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | RICHARD JIN
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Credential | MD
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Telephone | 951-880-0701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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