Provider Demographics
NPI:1922333723
Name:TEMECULA MEDICAL CORPORATION
Entity Type:Organization
Organization Name:TEMECULA MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:951-308-4451
Mailing Address - Street 1:41715 WINCHESTER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4808
Mailing Address - Country:US
Mailing Address - Phone:951-308-4451
Mailing Address - Fax:951-506-0992
Practice Address - Street 1:41715 WINCHESTER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4808
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:2009-10-12
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80692207X00000X, 207XX0005X
CAA75306261QU0200X
CAPA16522363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty