| Innovative Extensivist Group PC | |
|
44045 Margarita Rd Ste 101 Temecula CA 92592-2729 | |
| (951) 880-0701 | |
| (951) 904-3647 |
| Full Name | Innovative Extensivist Group PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 44045 Margarita Rd Ste 101, Temecula, California |
| Authorized Official Name and Position | Alma Torres (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9518008330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Extensivist Group PC 44045 Margarita Rd Ste 101 Temecula CA 92592-2729 Ph: (951) 880-0701 | Innovative Extensivist Group PC 44045 Margarita Rd Ste 101 Temecula CA 92592-2729 Ph: (951) 880-0701 |
| NPI Number | 1770467888 |
|---|---|
| Provider Enumeration Date | 08/01/2025 |
| Last Update Date | 08/12/2025 |
| Certification Date | 08/12/2025 |
| Medicare PECOS PAC ID | 4981106911 |
|---|---|
| Medicare Enrollment ID | O20250908002702 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770467888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | () | Secondary |
| Provider Name | Haena Min |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437387792 PECOS PAC ID: 0648422733 Enrollment ID: I20140203000929 |
| Provider Name | Sanjay P Muttreja |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447201173 PECOS PAC ID: 3476539230 Enrollment ID: I20150203002289 |
| Provider Name | Richard C Jin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053754366 PECOS PAC ID: 4880990597 Enrollment ID: I20170208002901 |
| Provider Name | Amelia Lynn Henninger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932634805 PECOS PAC ID: 6103246558 Enrollment ID: I20201023000932 |
| Provider Name | David Sea Jong Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740849066 PECOS PAC ID: 3375998842 Enrollment ID: I20231018003508 |
Azim U. Azhand, M.D. Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27450 Ynez Rd, Suite 108, Temecula, CA 92591 Phone: 951-695-4333 Fax: 951-695-4828 |
UC San Diego Health - Rancho Family Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 28780 Single Oak Dr Ste 160, Temecula, CA 92590 Phone: 951-694-1753 |
Innovative Medical Group Temecula Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 44045 Margarita Rd Ste 103, Temecula, CA 92592 Phone: 951-880-0701 Fax: 951-904-3647 |
Agm Medical Group, P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 27349 Jefferson Ave Ste 100, Temecula, CA 92590 Phone: 866-211-9447 Fax: 619-393-0840 |
Prestigious Medical Aesthetics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 40820 Winchester Rd Ste 2505, Temecula, CA 92591 Phone: 951-764-5962 |
All Family Care Medical Office Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41593 Winchester Rd Ste 101, Temecula, CA 92590 Phone: 951-695-8501 Fax: 951-695-8502 |