Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Parent organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Other names
FP&S OF LLUSM - MURRIETA
Organization subpart
Yes
Provider details
NPI number
Legal business name
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Authorized official
MS. LISA WOLTER (PROVIDER ENROLLMENT REPRESENTATIVE)
(909) 558-3289
Entity
Organization
Contact information
Practice address
28078 BAXTER RD, MURRIETA, CA 92563
(951) 290-6366
Mailing address
11165 MOUNTAIN VIEW AVE, STE 228, LOMA LINDA, CA 92354-3866
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207T00000X
Neurological Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
02/24/2011
Last updated
02/24/2011
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