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UROLOGY CENTER OF SO CALIF MEDICAL GROUP INC NPI 1982631412


NPI Information

NPI: 1982631412
Provider Name: UROLOGY CENTER OF SO CALIF MEDICAL GROUP INC
Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 05D0957666

Address:
28078 BAXTER RD
#450
MURRIETA, CA
ZIP 92563
Phone: (951) 677-3000
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UROLOGY CENTER OF SO CALIF MEDICAL GROUP INC is an urology in Murrieta, CA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. UROLOGY CENTER OF SO CALIF MEDICAL GROUP INC NPI is 1982631412. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

28078 BAXTER RD
#450
MURRIETA, CA
ZIP 92563-402
Phone: (951) 677-3000
Fax: (951) 672-4171

The provider's authorized official is Madhumitha C Reddy .
The authorized official title is Cfo and has the following contact phone number (951) 677-3000.

The CLIA number assigned to this NPI record is 05D0957666 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/28/2006 and was last updated on 9/9/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0090700MEDICAIDCALIFORNIA
2ZZZ02498ZOTHERCALIFORNIABLUE SHIELD
3ZZZ08232ZOTHERCALIFORNIABLUE SHIELD
4GR0090703MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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