PERRIS VALLEY MEDICAL GROUP, INC. (NPI# 1083851703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083851703 |
| Entity Type | Organization |
| Organization Name | PERRIS VALLEY MEDICAL GROUP, INC. |
| Practice Address |
126 Avocado Ave Suite 207 Perris CA 92571-2605 |
| Practice Telephone | 9516570544 |
| Practice Fax Number | 9516579644 |
| Mailing Telephone | 9516570544 |
| Mailing Fax Number | 9516579644 |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2012-02-09 |
| Authorized Official Name | GEORGE VILLANUEVA (PRESIDENT) |
| Authorized Official Telephone | 9516570544 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20A6023 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | E90354 | 05 |
| Street Address |
126 AVOCADO AVE SUITE 207 |
| City | PERRIS |
| State | CA |
| Zip Code | 92571-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831173129 | Jose De Jesus Alvarez | Physical Therapist | 126 Avocado Ave, Suite 107, Perris, CA 92571-2605 | 2005-12-01 |
| 1396108403 | Avocado Medical Clinic Professional Corp | Clinic/Center | 126 Avocado Ave, Perris, CA 92571-2605 | 2016-04-05 |
| 1184099186 | Dang M Ngo | Physical Therapist | 126 Avocado Ave, Suite 107, Perris, CA 92571-2605 | 2015-12-02 |
| 1942584727 | Daniel's Pharmacy Inc | Pharmacy | 126 Avocado Ave, Suite 101, Perris, CA 92571-2605 | 2011-09-28 |
| 1972809986 | Ashley Maycock Jacobs | Physical Therapist | 126 Avocado Ave, Suite 107, Perris, CA 92571-2605 | 2011-02-09 |
| 1154512416 | Donna Marie Hefner | Physician Assistant | 126 Avocado Ave, Ste 106, Perris, CA 92571-2605 | 2007-08-01 |
| 1215014089 | Brian Alan Smith | Physical Therapist | 126 Avocado Ave, Suite 107, Perris, CA 92571-2605 | 2006-11-01 |
| 1780790485 | Diana Rose Irving | Social Worker | 126 Avocado Ave, Suite 103, Perris, CA 92571-2605 | 2006-08-22 |
| 1023086790 | Rancho Physical Therapy, Inc. | Physical Therapist | 126 Avocado Ave, Ste 107, Perris, CA 92571-2605 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376199422 | Pico De Loro, Incorporated | Assisted Living Facility | 620 North Perris Boulevard, Perris, CA 92571 | 2019-08-14 |
| 1053802579 | Kadiatou Dafney | Nurse Practitioner | 126 Avocado Ave Ste 106, Perris, CA 92571 | 2018-05-21 |
| 1730677014 | Ruth Gasselle Rodriguez | Nutritionist | 1020 Huntington Way, Perris, CA 92571 | 2018-04-23 |
| 1649788167 | Leslie Bautista | Counselor | 1276 Autumnwood Ln, Perris, CA 92571 | 2018-01-18 |
| 1588180459 | Eduardo Orozco-zavala | Licensed Vocational Nurse | 85 Ramona Expressway, Suite 1, Perris, CA 92571 | 2017-08-22 |
| 1396267365 | National Vision, Inc. | Technician/Technologist | 1850 N Perris Boulevard, Suite 40, Perris, CA 92571 | 2017-07-12 |
| 1336669506 | Gary Huang | Optometrist | 1850 N Perris Boulevard Ste 40, Perris, CA 92571 | 2017-06-20 |
| 1750814745 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 106 Worth St, Perris, CA 92571 | 2017-04-06 |
| 1013456235 | Sohal and Pham Dental Corporation | Dentist | 1820 Perris Blvd, Suite 70, Perris, CA 92571 | 2017-02-21 |
| 1093267569 | New Beginnings Residential Tf | Residential Treatment Facility, Emotionally Disturbed Children | 2464 Slew of Gold Ct, Perris, CA 92571 | 2016-10-31 |
| Find all providers in zip 92571 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689094757 | Gloria Michelle Ventura | Family Medicine | 1675 N Perris Blvd Ste G1, Perris, CA 92571-4748 | 2014-04-16 |
| 1225229446 | Keyla Sarai Monterrey | Family Medicine | 309 E. San Jacinto Avenue, Perris, CA 92570 | 2007-08-05 |
| 1669675443 | Ruth Chambi Hernandez | Family Medicine | 333 Wilkerson Ave, Suites B&c, Perris, CA 92570-2211 | 2007-06-07 |
| 1902977614 | Somchit T Poommipanit | Family Medicine | 2055 N. Perris Blvd., E6, Perris, CA 92571-2518 | 2006-11-13 |
| 1316016389 | Roswitha Elisabeth Breuer | Family Medicine | 146 E 4th St, Perris, CA 92570-2125 | 2006-11-06 |
| 1427132620 | George Villanueva | Family Medicine | 126 Avocado Ave Ste 207, Perris, CA 92571 | 2006-10-24 |
| 1194832816 | Octavio Ruiz-villalpando | Family Medicine | 735 S D St, Perris, CA 92570-2419 | 2006-08-25 |
| 1174597082 | Gabriel Martin Del Campo | Family Medicine | 2226 Medical Center Dr Ste 102, Perris, CA 92571-2657 | 2006-02-15 |
| 1093323933 | Bawj Medical Services | Family Medicine | 524 W 4th St Ste B, Perris, CA 92570-2016 | 2020-07-16 |
| 1831548197 | Poom Medical Clinic Inc | Family Medicine | 2055 N Perris Blvd Ste E6, Perris, CA 92571-2517 | 2016-06-08 |
| Find all providers in PERRIS | ||||
Please comment or provide details below to improve the information on PERRIS VALLEY MEDICAL GROUP, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.