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
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