Organization
SAN LUIS REY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MOUTON (SR VP OPERATIONS)
(949) 240-7200
Entity
Organization
Contact information
Practice address
27710 JEFFERSON AVE STE 207, TEMECULA, CA 92590-4604
(833) 668-6676
(866) 299-8639
Mailing address
6400 OAK CYN, SUITE 200, IRVINE, CA 92618-5203
(858) 229-6156
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
11/30/2016
Last updated
07/19/2024
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