Provider Demographics
NPI:1659323293
Name:US HEALTHWORKS MEDICAL GROUP PC
Entity Type:Organization
Organization Name:US HEALTHWORKS MEDICAL GROUP PC
Other - Org Name:MURRIETA VALLEY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:OKUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-565-1300
Mailing Address - Street 1:5575 RUFFIN ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1314
Mailing Address - Country:US
Mailing Address - Phone:858-565-1300
Mailing Address - Fax:858-565-6932
Practice Address - Street 1:25285 MADISON AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8954
Practice Address - Country:US
Practice Address - Phone:950-600-9070
Practice Address - Fax:951-600-9177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S. HEALTHWORKS MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-16
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2083P0500X, 225100000X
CAPT 25605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04797ZOtherBLUE SHIELD
CAZZZ20916ZMedicare PIN