MEDICARE: ASSOCIATED WOMENS HEALTHCARE OF THE INLAND VALLEY, A MED. CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization	A39837	CA

General Provider Information

NPI Number	:	1770702821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED WOMENS HEALTHCARE OF THE INLAND VALLEY, A MED. CORP

Provider Business Mailing Address
First Line	:	43596 MANZANO DR
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92592-2610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36450 INLAND VALLEY DR
Second Line	:	SUITE 102
City	:	WILDOMAR
State	:	CA
Zip	:	92595-9583
Country	:	US
Telephone Number	:	951-461-3311
Fax Number	:	951-461-2833

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN ANTHONY BYRNE
Credential	:	M.D.
Telephone Number	:	951-461-3311

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

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