Abundant Health Medical Inc
Organization Active NPI Family Medicine Physician · Temecula, CA
NPI 1669291316 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1669291316
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ABUNDANT HEALTH MEDICAL INC
- Practice address
- 27450 Ynez Rd Ste 128
Temecula, CA 92591-4680 - Phone
- (951) 383-4333
- NPI assigned
- Oct 9, 2024
- Organization subpart
- No
Authorized official
- Name
- Michelle Christine Myers
- Title
- Assistant Office Manager
- Phone
- (951) 383-4333
Practitioners 2
-
Jonathan Vellinga, M.D.
-
Tara M Elrod, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2322752 | Abundant Health Medical Inc | Certificate of waiver | Apr 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250221002657 | CA | Part B Supplier - Clinic/Group Practice | 6002336997 |
Receives reassigned benefits from 2 practitioners Practice locations: Temecula, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
27450 Ynez Rd Ste 128
Temecula, CA 92591-4680
Mailing address
27450 Ynez Rd Ste 128
Temecula, CA 92591-4680
Phone (951) 383-4333
Other names
- Abundant Health
Other providers in Temecula, CA
- Ingrid M Abrams
- Mayra Natalie Abrego
- Reyley Abrenilla
- Rosanny Abreu Contrera
- Kinsey Abt
- Yoselin Abundio
- Accent Permanent Makeup Studio,LLC
- Daniela Acevedo
- Lara Aceves
- Ogemdi Achara
All providers in Temecula, CA · Family Medicine 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 Oct 9, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.