Spa M Medical Corporation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

20A8981 Issued in CA

Legal business name

SPA M MEDICAL CORPORATION

Practice address

32034 Blazing Star St
Winchester, CA 92596-8941

Phone

(951) 325-8307

NPI assigned

Jun 15, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Dennnis K. Miller, D.O.

Title

Ceo

Phone

(714) 465-7125

Specialties & licenses 1

Addresses

Tax ID family

Spa M Medical Corporation2 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.

• Spa M Medical Corporation

  • Primary Care Clinic/Center
  • Temecula, CA
  • NPI 1215358502
  NPD tax ID

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1578790713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32034 BLAZING STAR ST",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968941",
            "telephone_number": "951-325-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32034 BLAZING STAR ST",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968941",
            "telephone_number": "951-325-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA M MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DENNNIS",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-465-7125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "20A8981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Shubin, M.S., CCC-SLP
• Tabitha Louise Smith, RN
• Jeffrey Snow
• Maria Celeste Solomon, CCC-SLP
• Soul Grit Marriage and Family Counseling Services, Inc.
• Sprout Pediatric Behavioral Services LLC
• Kelly C Starbuck, MA, BCBA
• Nicole Stock, LPC
• Brenda Lynn Stover, RD
• Taylor Stratton, MS CCC-SLP

• Rural Health Clinic/Center in Winchester, CA
• Providers in Winchester, CA by specialty
• Rural Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.