Provider Demographics
NPI:1457657389
Name:TEMECULA MEDICAL CORPORAION
Entity Type:Organization
Organization Name:TEMECULA MEDICAL CORPORAION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-308-4451
Mailing Address - Street 1:41715 WINCHESTER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4853
Mailing Address - Country:US
Mailing Address - Phone:951-308-4451
Mailing Address - Fax:951-506-0992
Practice Address - Street 1:41715 WINCHESTER RD STE 102
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4853
Practice Address - Country:US
Practice Address - Phone:951-308-4451
Practice Address - Fax:951-506-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty