Murrieta Valley Family Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G453820 Issued in CA

Legal business name

MURRIETA VALLEY FAMILY MEDICAL GROUP, INC.

Practice address

24910 Las Brisas Rd Ste 121
Murrieta, CA 92562-4035

Phone

(951) 698-7550

Fax

(951) 698-1521

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Robert G Peterson, M.D.

Title

Ceo

Phone

(951) 698-7550

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1124172796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD STE 121",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624035",
            "telephone_number": "951-698-7550",
            "fax_number": "951-698-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD STE 121",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624035",
            "telephone_number": "951-698-7550",
            "fax_number": "951-698-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MURRIETA VALLEY FAMILY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-698-7550",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G453820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brody Austin Myers

• Specialist in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.