Livingwater's Medical Clinic, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

20A8759 Issued in CA

Legal business name

LIVINGWATER'S MEDICAL CLINIC, INC.

Practice address

24910 Las Brisas Rd
Suite 111
Murrieta, CA 92562-4010

Phone

(951) 694-8549

Fax

(951) 220-8307

NPI assigned

Jul 10, 2006

Last updated

Nov 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jonathan Yujung Yun, D.O.NPI 1275572349

Title

President

Phone

(951) 694-8549

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Livingwater's Medical Clinic, Inc.

  • Family Medicine Physician
  • Hemet, CA
  • NPI 1073041851

  O20060718000417

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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.

• Jonathan Yujung Yun, D.O.

  • Family Medicine Physician
  • Murrieta, CA
  • NPI 1275572349
  Medicare reassignment Care Compare group NPD Authorized official
• Kushan Ketan Shah

  • Physician Assistant
  • Colton, CA
  • NPI 1750005849
  Medicare reassignment Care Compare group NPD
• Jasmina Ponjavic Dillon, PA-C

  • Medical Physician Assistant
  • Menifee, CA
  • NPI 1851577969
  Medicare reassignment Care Compare group
• Tanya Peltz, PA

  • Physician Assistant
  • West Covina, CA
  • NPI 1285129049
  Medicare reassignment Care Compare group
• David L Brand, P.A.

  • Surgical Physician Assistant
  • Walnut Creek, CA
  • NPI 1346366556
  NPD (past)
• Brett Campfield, FNP-C

  • Nurse Practitioner
  • Carlsbad, CA
  • NPI 1124642954
  NPD (past)
• Jennifer Chiu, M.D.

  • Internal Medicine Physician
  • Hawthorne, CA
  • NPI 1962528430
  NPD (past)
• Kaylene K Oh, N.P.

  • Nurse Practitioner
  • Murrieta, CA
  • NPI 1396939831
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1992738991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD",
            "address_2": "SUITE 111",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624010",
            "telephone_number": "951-694-8549",
            "fax_number": "951-220-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD",
            "address_2": "SUITE 111",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624010",
            "telephone_number": "951-694-8549",
            "fax_number": "951-220-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGWATER'S MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "YUN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "YUJUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-694-8549",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "20A8759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX87590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Littlefield Physical Therapy, Inc.
• Littlefield Physical Therapy, Inc.
• Melissa D Littlefield, P.T.
• Adriana Litz, LVN
• Sindy Liu, PHARM.D.
• Liza Alvarado DNP a Professional Nursing Corporation (HealtheRoad A Professional Nursing Corporation)
• Miranda Lizarraga
• Vanessa Lizarraga
• Michaela Lloyd, PT, DPT
• Jennifer Loa, LVN

• Primary Care Clinic/Center in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.