NPIMap

Organization Active NPI

Menifee Valley Medical Association

  • Case Management Agency
  • Sun City, CA
National Provider Identifier
1649467093
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
G61994 Issued in CA
Legal business name
MENIFEE VALLEY MEDICAL ASSOCIATION
Practice address
29798 Haun Rd Ste 203
Sun City, CA 92586-6541
Phone
(951) 301-9188
Fax
(951) 672-6132
NPI assigned
Oct 1, 2007
Last updated
Feb 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Dr. John Robert Haynes, M.D.
Title
President
Phone
(951) 301-9188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X G61994 CA Primary

Addresses

Primary practice location

29798 Haun Rd Ste 203
Sun City, CA 92586-6541

Mailing address

29798 Haun Rd Ste 203
Sun City, CA 92586-6541
Phone (951) 301-9188

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1649467093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29798 HAUN RD STE 203",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866541",
            "telephone_number": "951-301-9188",
            "fax_number": "951-672-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29798 HAUN RD STE 203",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866541",
            "telephone_number": "951-301-9188",
            "fax_number": "951-672-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENIFEE VALLEY MEDICAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-301-9188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "G61994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.