Provider Demographics
NPI:1770559981
Name:UNITED MEDICAL DOCTORS
Entity type:Organization
Organization Name:UNITED MEDICAL DOCTORS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-566-5229
Mailing Address - Street 1:28078 BAXTER RD STE 530
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-1405
Mailing Address - Country:US
Mailing Address - Phone:951-566-5229
Mailing Address - Fax:951-566-5554
Practice Address - Street 1:28078 BAXTER RD STE 530
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1405
Practice Address - Country:US
Practice Address - Phone:951-566-5229
Practice Address - Fax:951-566-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X, 207LP2900X, 367500000X
CA20A4364207RG0100X
CAA63582207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0050840Medicaid
H54883Medicare UPIN
CAGR0050840Medicaid
A93575Medicare UPIN
CAZZZ27421ZMedicare ID - Type Unspecified