# LIVINGWATER'S MEDICAL CLINIC, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073041851
- **Authorized official:** TRACY KUVEKE (BILLER)
- **Authorized official phone:** (951) 694-8549

## Contact information

- **Practice address:** 255 N GILBERT ST STE C2, HEMET, CA 92543-4078
- **Practice address phone:** (951) 694-8549
- **Mailing address:** 24910 LAS BRISAS RD STE 111, MURRIETA, CA 92562-4010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 20A8759 | CA | Yes |

## Other

- **Enumeration date:** 05/24/2017
- **Last updated:** 05/24/2017