Provider Demographics
NPI:1407845092
Name:TEMECULA VALLEY EMERGENCY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:TEMECULA VALLEY EMERGENCY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:951-696-2850
Mailing Address - Street 1:7725 W RENO AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-9742
Mailing Address - Country:US
Mailing Address - Phone:800-962-3303
Mailing Address - Fax:305-929-0765
Practice Address - Street 1:28062 BAXTER RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1401
Practice Address - Country:US
Practice Address - Phone:951-290-4108
Practice Address - Fax:951-290-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0063700Medicaid
CAGR0063700Medicaid
CAZZZ00301ZMedicare PIN