Organization
JON L SIEMS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ANN PORTER (PRACTICE MANAGER)
(951) 303-6111
Entity
Organization
Contact information
Practice address
31515 RANCHO PUEBLO RD STE 103, TEMECULA, CA 92592-4837
(951) 303-6111
(951) 302-4448
Mailing address
31515 RANCHO PUEBLO RD STE 103, TEMECULA, CA 92592-4837
(951) 303-6111
(951) 302-4448
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
54383
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54383
CA MEDICAL LICENSE
CA
Enumeration date
09/07/2017
Last updated
03/07/2023
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