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Organization
MORENO VALLEY MEDICAL GROUP, INC
Active
Organization
MORENO VALLEY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY P RICHARDS SR. CMAIII (OFFICE MANAGER)
(951) 242-9595
Entity
Organization
Contact information
Practice address
24490 SUNNYMEAD BLVD, MORENO VALLEY, CA 92553-7734
(951) 242-9595
Mailing address
24490 SUNNYMEAD BLVD STE 117, MORENO VALLEY, CA 92553-7764
(951) 242-9595
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A703100
—
CA
Enumeration date
03/05/2020
Last updated
03/07/2023
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