Organization
TEMECULA EYE MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BERWYN SMITH M.D. (PRES)
(951) 296-2244
Entity
Organization
Contact information
Practice address
41877 ENTERPRISE CIR N, STE. 110, TEMECULA, CA 92590-5656
(951) 296-2244
(951) 296-3713
Mailing address
41877 ENTERPRISE CIR N, STE. 110, TEMECULA, CA 92590-5656
(951) 296-2244
(951) 296-3713
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G28719
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G28791
—
CA
01
—
180013990
RAILROAD MEDICARE
CA
01
—
BLUE CROSS BLUE SHIE
ZZZ39567Z
CA
Enumeration date
09/01/2006
Last updated
05/14/2008
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