Organization
TEMECULA VALLEY PAIN MEDICAL GROUP
Active
Organization
TEMECULA VALLEY PAIN MEDICAL GROUP
Active
Other names
University Spine Institute
Organization subpart
No
Provider details
NPI number
Authorized official
VANCE ZACHARY JOHNSON M.D. (PRESIDENTCEO)
(951) 894-5000
Entity
Organization
Contact information
Practice address
28078 BAXTER RD, SUITE 128, MURRIETA, CA 92563-1402
(951) 894-5000
(951) 296-1098
Mailing address
27475 YNEZ RD # 295, TEMECULA, CA 92591-4612
(951) 894-5000
(951) 296-1098
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ09959Z
BLUE SHIELD ID #1
CA
01
—
ZZZ09960Z
BLUE SHIELD ID #2
CA
Enumeration date
07/17/2006
Last updated
12/30/2013
Update your record
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