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Organization
LIVINGWATER'S MEDICAL CLINIC, INC.
Active
Organization
LIVINGWATER'S MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY KUVEKE (BILLER)
(951) 694-8549
Entity
Organization
Contact information
Practice address
255 N GILBERT ST STE C2, HEMET, CA 92543-4078
(951) 694-8549
Mailing address
24910 LAS BRISAS RD STE 111, MURRIETA, CA 92562-4010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A8759
CA
Other
Enumeration date
05/24/2017
Last updated
05/24/2017
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