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 Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207RC0000X | Internal Medicine | Cardiovascular Disease | A53427 | CALIFORNIA | Yes |
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 Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | G64785 | MEDICARE UPIN | CALIFORNIA | |
| 2 | 00A534270 | MEDICAID | CALIFORNIA | |
| 3 | 00A534271 | MEDICARE PIN | CALIFORNIA | |
| 4 | 00A534270 | MEDICARE ID-TYPE UNSPECIFIED | CALIFORNIA | 44274 GEORGE CUSHMAN TEME |
| 5 | 00A534270 | OTHER | CALIFORNIA | 31565 RANCHO PUEBLE STE 102 TEMECULA, CA 92592 MEDICARE NHIC |
| 6 | DN6409 | OTHER | CALIFORNIA | RAILROAD MEDICARE |
| 7 | 00A534270 | MEDICARE ID-TYPE UNSPECIFIED | CALIFORNIA | NHIC MEDICARE NUMBER |
| 8 | G64785 | MEDICAID | CALIFORNIA | |
| 9 | 110219240 | OTHER | | RAILROAD MEDICARE |
| 10 | 00A534271 | MEDICAID | CALIFORNIA | |
| 11 | ZZZ06360Z | MEDICARE PIN | CALIFORNIA | |
| 12 | 00A534271 | OTHER | CALIFORNIA | MEDICARE NHIC 31565 RANCHO PUEBLO STE 102 TEMECULA CA 92592 |
