Livingwater's Medical Clinic, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A8759 Issued in CA

Legal business name

LIVINGWATER'S MEDICAL CLINIC, INC.

Practice address

255 N Gilbert St Ste C2
Hemet, CA 92543-4078

Phone

(951) 694-8549

NPI assigned

May 24, 2017

Last updated

May 24, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy Kuveke

Title

Biller

Phone

(951) 694-8549

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Livingwater's Medical Clinic, Inc.

  • Primary Care Clinic/Center
  • Murrieta, CA
  • NPI 1992738991

  O20060718000417

  Same enrollment

Tax ID family

Livingwaters Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Anza Community Medical Center

  • Primary Care Clinic/Center
  • Anza, CA
  • NPI 1619000775
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Anza Community Medical Center Corp

  dba Anza Community Medical Center

  • Clinic/Center
  • Anza, CA
  • NPI 1942485610

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David L Brand, P.A.

  • Surgical Physician Assistant
  • Walnut Creek, CA
  • NPI 1346366556
  NPD (past)
• Chang Hyun Oh, M.D.

  • Family Medicine Physician
  • Temecula, CA
  • NPI 1477613941
  NPD (past)
• Kaylene K Oh, N.P.

  • Nurse Practitioner
  • Murrieta, CA
  • NPI 1396939831
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495584000000",
    "number": "1073041851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD STE 111",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N GILBERT ST STE C2",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434078",
            "telephone_number": "951-694-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGWATER'S MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-05-24",
        "status": "A",
        "authorized_official_last_name": "KUVEKE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "951-694-8549"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dandrich Yuan Lim, MD
• Christina Hsin-Chieh Lin, D.D.S., M.S.
• Myo Lin
• Kathleen Ann Linke, PA-C
• Zachary Little
• Mary Grace Loar, MFT
• Ericson Lobusta
• Curtis Ramon Loeffler, D.C.
• Robert A Loera, MD
• Loma Linda Vamc

• Family Medicine Physician in Hemet, CA
• Providers in Hemet, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.