Temecula Valley Cardiology Medical Group, Inc
Organization Active NPI Cardiovascular Disease Physician · Bonsall, CA
NPI 1346466646 · NPPES record last updated Jul 8, 2024
Key facts
- NPI
- 1346466646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- TEMECULA VALLEY CARDIOLOGY MEDICAL GROUP, INC
- Practice address
- 5256 S. Mission Road
Suite 802
Bonsall, CA 92003-3623 - Phone
- (760) 945-3600
- Fax
- (951) 514-2542
- NPI assigned
- Apr 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Leslie Shaeffer
- Title
- Practice Manager
- Phone
- (951) 698-4600
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 1
Practitioners 6
-
Henry M. Lo, MD
-
Robert N Berkley, MD
-
Desiree Reedus, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040603000860 | CA | Part B Supplier - Clinic/Group Practice | 6103808134 |
Receives reassigned benefits from 9 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Temecula, CA; Wildomar, CA; Murrieta, CA; Menifee, CA; Bonsall, CA |
National Provider Directory
- Tax ID family
- Temecula Valley Cardiology
Locations
589 E Elder St
Fallbrook, CA 92028
Phone (619) 723-3600
32605 Temecula Pkwy
Ste 211
Temecula, CA 92592
Phone (951) 303-8826
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61419
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes |
Addresses
Primary practice location
5256 S. Mission Road
Suite 802
Bonsall, CA 92003-3623
Mailing address
25470 Medical Center Dr Ste 105
Murrieta, CA 92562-4901
Phone (951) 698-4600
Other providers in Bonsall, CA
- Shahid Javery MD a Professional Corporation
- Michele Linden Shaw
- Brian M Smith
- Kerry Lynn Stavinoha
- Synergy Healing Work
- Neil W. Treister
- Tru-Health Enterprises, Inc.
- Vance Chiropractic, Inc.
- Veterans Foundation, Inc.
- Victor L Kovner MD Facp
All providers in Bonsall, CA · Cardiovascular Disease Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.