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Organization

LAKE ELSINORE CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION

Active
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Organization

LAKE ELSINORE CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION

Active
Other names
Lake Elsinore Clinica Medica Familiar
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OCTAVIO RUIZ-VILLALPANDO M.D. (PRESIDENT)
(951) 245-0505
Entity
Organization

Contact information

Practice address
31739 RIVERSIDE DR, SUITE A-1, LAKE ELSINORE, CA 92530-7818
(951) 245-0505
(951) 245-0999
Mailing address
31739 RIVERSIDE DR, SUITE A-1, LAKE ELSINORE, CA 92530-7818
(951) 245-0505
(951) 245-0999

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A92039
CA

Other

Enumeration date
10/01/2009
Last updated
10/01/2009
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