| Organization Name: | MORENO VALLEY CMF |
| NPI Number: | 1043310238 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT RODRIGUEZ (PHYSICIAN ASSISTANT) |
| Mailing Address: | 23080 Alessandro Blvd Suite 202 Moreno Valley |
| State: | CA US |
| Postal Code: | 925539673 |
| Phone Number: | 9516977866 |
| Fax Number: | 9516977869 |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | PA10518 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |