Provider Demographics
NPI:1053751941
Name:TEMECULA MEDICAL GROUP INC
Entity type:Organization
Organization Name:TEMECULA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:RAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:951-302-2526
Mailing Address - Street 1:27555 YNEZ RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-4677
Mailing Address - Country:US
Mailing Address - Phone:951-302-2526
Mailing Address - Fax:833-937-2808
Practice Address - Street 1:27555 YNEZ RD STE 102
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4677
Practice Address - Country:US
Practice Address - Phone:951-302-2526
Practice Address - Fax:833-937-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty