Provider Demographics
NPI:1831686591
Name:HEMET VALLEY MEDICAL CENTER
Entity type:Organization
Organization Name:HEMET VALLEY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-840-6401
Mailing Address - Street 1:535 E STATE ROUTE 133
Mailing Address - Street 2:
Mailing Address - City:ARCOLA
Mailing Address - State:IL
Mailing Address - Zip Code:61910-3793
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1117 E DEVONSHIRE AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3083
Practice Address - Country:US
Practice Address - Phone:951-652-2811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center