Organization
OLIVEIRA MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS EDWARD OLIVEIRA D.O. (OWNER)
(951) 471-5116
Entity
Organization
Contact information
Practice address
506 W GRAHAM AVE, STE 107, LAKE ELSINORE, CA 92530
(951) 471-5116
(951) 471-5226
Mailing address
506 W GRAHAM AVE, STE 107, LAKE ELSINORE, CA 92530
(951) 471-5116
(951) 471-5226
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20A7032
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX70320
—
CA
Enumeration date
08/29/2006
Last updated
08/22/2020
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