Provider Demographics
NPI:1952897654
Name:PLATINUM WOMEN'S HEALTH AND WELLNESS-TEMECULA
Entity Type:Organization
Organization Name:PLATINUM WOMEN'S HEALTH AND WELLNESS-TEMECULA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-677-0215
Mailing Address - Street 1:25495 MEDICAL CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4904
Mailing Address - Country:US
Mailing Address - Phone:951-677-0215
Mailing Address - Fax:
Practice Address - Street 1:31170 TEMECULA PKWY STE 201
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2915
Practice Address - Country:US
Practice Address - Phone:951-677-0215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLATINUM WOMEN'S HEALTH AND WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty