Tri-Valley Surgey, a Professional Medical Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A86585 Issued in CA

Legal business name

TRI-VALLEY SURGEY, A PROFESSIONAL MEDICAL CORPORATION

Practice address

36243 Inland Valley Dr Ste 40
Wildomar, CA 92595-9547

Phone

(951) 894-2620

Fax

(951) 894-2622

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Seunghwan Oh, MD

Title

President

Phone

(951) 894-2620

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609099381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR STE 40",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959547",
            "telephone_number": "951-894-2620",
            "fax_number": "951-894-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR STE 40",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959547",
            "telephone_number": "951-894-2620",
            "fax_number": "951-894-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-VALLEY SURGEY, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SEUNGHWAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-894-2620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A86585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.