# LAS PALMAS MEDICAL GROUP

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

## Provider details

- **NPI number:** 1164503652
- **Authorized official:** DR. IRMA LOPEZ M.D. (PRESIDENT OWNER)
- **Authorized official phone:** (951) 652-0090

## Contact information

- **Practice address:** 1003 N. STATE STREET, HEMET, CA 92543-4435
- **Practice address phone:** (951) 652-0090
- **Practice address fax:** (951) 652-0907
- **Mailing address:** 1003 N. STATE STREET, HEMET, CA 92543-4435
- **Mailing address phone:** (951) 652-0090
- **Mailing address fax:** (951) 652-0907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0094631 | — | CA |