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29995 Technology Dr Suite 201 Murrieta CA 92563-2632 | |
(951) 461-3021 | |
(951) 461-8898 |
Full Name | |
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Speciality | Family Medicine |
Location | 29995 Technology Dr, Murrieta, California |
Authorized Official Name and Position | Laurie Blanscet (PHYSICIAN) |
Authorized Official Contact | 9514613021 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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29995 Technology Dr Suite 201 Murrieta CA 92563-2632 Ph: (951) 461-3021 | 29995 Technology Dr Suite 201 Murrieta CA 92563-2632 Ph: (951) 461-3021 |
NPI Number | 1518026848 |
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Provider Enumeration Date | 12/06/2006 |
Last Update Date | 06/07/2019 |
Medicare PECOS PAC ID | 0648229203 |
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Medicare Enrollment ID | O20050120000829 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518026848 | NPI | - | NPPES |
10942752 | Other | CA | CAQH |
DG7185 | Other | CA | MEDICARE RAILROAD GROUP NO. |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20A7007 (California) | Primary |
Provider Name | Laurie J Blanscet |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154399954 PECOS PAC ID: 3072562636 Enrollment ID: I20050121000304 |
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