Spa M Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A8981 Issued in CA

Legal business name

SPA M MEDICAL CORPORATION

Practice address

27520 Ynez Rd
C5
Temecula, CA 92591-4650

Phone

(951) 694-4200

NPI assigned

Jan 29, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Miller, MD

Title

Owner

Phone

(951) 694-4200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1609299536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27636 YNEZ RD",
            "address_2": "L7 NO 274",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915600",
            "telephone_number": "951-694-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27520 YNEZ RD",
            "address_2": "C5",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925914650",
            "telephone_number": "951-694-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA M MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-694-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Temecula, CA
• Providers in Temecula, 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 Jan 29, 2014; 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.