# ADVANCED MANAGEMENT PRACTICE PHYSICIAN ASSISTANT CORPORATION

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

## Provider details

- **NPI number:** 1174346498
- **Authorized official:** ALLEN MARTIN PHELPS PA-C (PRESIDENT)
- **Authorized official phone:** (760) 400-6375

## Contact information

- **Practice address:** 41715 WINCHESTER RD STE 107, TEMECULA, CA 92590-4853
- **Practice address phone:** (951) 501-0049
- **Practice address fax:** (833) 585-1122
- **Mailing address:** 4225 EXECUTIVE SQ STE 600, PMB6042, LA JOLLA, CA 92037
- **Mailing address phone:** (760) 400-6375
- **Mailing address fax:** (858) 216-8050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2024
- **Last updated:** 12/10/2024