Provider Demographics
NPI:1801278718
Name:TEMECULA VALLEY CARDIOLOGY MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:TEMECULA VALLEY CARDIOLOGY MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-698-4600
Mailing Address - Street 1:25470 MEDICAL CENTER DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4901
Mailing Address - Country:US
Mailing Address - Phone:951-698-4600
Mailing Address - Fax:951-514-2542
Practice Address - Street 1:31565 RANCHO PUEBLO RD
Practice Address - Street 2:200
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4838
Practice Address - Country:US
Practice Address - Phone:951-698-4600
Practice Address - Fax:951-514-2542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty