Individual provider Active NPI

Emmanuel Awdishu, MD

  • Family Medicine Physician
  • Temecula, CA
National Provider Identifier
1720630205
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A195110 Issued in CA
Practice address
31720 Temecula Pkwy Ste 203
Temecula, CA 92592-5895
Phone
(951) 302-4700
Fax
(951) 302-4701
NPI assigned
Jul 15, 2019
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A195110 CA Primary

Addresses

Primary practice location

31720 Temecula Pkwy Ste 203
Temecula, CA 92592-5895

Mailing address

31720 Temecula Pkwy Ste 203
Temecula, CA 92592-5895
Phone (951) 302-4700

Other practice location 1

3989 W Stetson Ave Ste 100
Hemet, CA 92545-9696
Phone (951) 302-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220630000178 MI Practitioner - Family Practice 6204163306 Reassigns benefits to 3 organizations
I20250310001911 CA Practitioner - Family Practice 6204163306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temecula Valley Family Physicians Inc.Group PAC ID 6507954401, 5 clinicians

Practice addresses (Care Compare)

31720 Temecula Pkwy
Suite 203
Temecula, CA 92592-5895
Phone (951) 302-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A195110CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temecula Valley Family Physicians Inc. Family Medicine CurrentSince Dec 22, 2024 Accepting new patients
Vituity - Michigan Hospitalists PC Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Dec 1, 2022 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Dec 1, 2022 Accepting new patients
Iep - Post Acute Care PLLC Family Medicine CurrentSince Aug 28, 2023 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Pathology Current Accepting new patients

Locations

3989 W Stetson Ave
Ste 100
Hemet, CA 92545
Phone (951) 302-4700

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

31720 US Highway 79
Ste 203
Temecula, CA 92592
Phone (951) 302-4700

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

205 N East Ave
Fl 2
Jackson, MI 49201
Phone (517) 205-7060

505 N Jackson St
Jackson, MI 49201
Phone (517) 748-5500

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: eawdishu597074@direct.hfhs.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1720630205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31720 TEMECULA PKWY STE 203",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925895",
            "telephone_number": "951-302-4700",
            "fax_number": "951-302-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31720 TEMECULA PKWY STE 203",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925895",
            "telephone_number": "951-302-4700",
            "fax_number": "951-302-4701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3989 W Stetson Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925459696",
            "country_code": "US",
            "telephone_number": "951-302-4700",
            "fax_number": "951-302-4701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWDISHU",
        "first_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A195110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.