| Total Care Family Medical Center Of Lake Elsinore, Inc. | |
|
425 Diamond Drive Suite 105 Lake Elsinore CA 92530 | |
| (951) 674-8779 | |
| Not Available |
| Full Name | Total Care Family Medical Center Of Lake Elsinore, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 425 Diamond Drive, Lake Elsinore, California |
| Authorized Official Name and Position | Na'imah D Powell (OWNER) |
| Authorized Official Contact | 9516748779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Care Family Medical Center Of Lake Elsinore, Inc. 425 Diamond Drive Suite 105 Lake Elsinore CA 92530 Ph: (951) 674-8779 | Total Care Family Medical Center Of Lake Elsinore, Inc. 425 Diamond Drive Suite 105 Lake Elsinore CA 92530 Ph: (951) 674-8779 |
| NPI Number | 1992950703 |
|---|---|
| Provider Enumeration Date | 11/20/2008 |
| Last Update Date | 11/20/2008 |
| Medicare PECOS PAC ID | 7810050507 |
|---|---|
| Medicare Enrollment ID | O20090106000732 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992950703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G72993 (California) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Na'imah Powell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720057623 PECOS PAC ID: 7113981770 Enrollment ID: I20041115000548 |
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