Organization
ASPEN MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IHEANACHO EMERUWA M.D. (MEDICAL DIRECTOR)
(951) 343-3477
Entity
Organization
Contact information
Practice address
9041 MAGNOLIA AVE STE 305, RIVERSIDE, CA 92503-3957
(951) 343-3477
(951) 343-3486
Mailing address
9041 MAGNOLIA AVE STE 305, RIVERSIDE, CA 92503-3957
(951) 343-3477
(951) 343-3486
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0094761
—
CA
01
—
ZZZ28499Z
MEDICARE PTAN #
CA
Enumeration date
10/05/2006
Last updated
02/07/2024
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