| Organization Name: | LAS PALMAS MEDICAL GROUP |
| NPI Number: | 1164503652 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IRMA LOPEZ (PRESIDENT OWNER) |
| Mailing Address: | 1003 N. State Street Hemet |
| State: | CA US |
| Postal Code: | 925434435 |
| Phone Number: | 9516520090 |
| Fax Number: | 9516520907 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |