Provider Demographics
NPI:1730385535
Name:APEX HEALTHCARE MEDICAL CENTER INC
Entity type:Organization
Organization Name:APEX HEALTHCARE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-652-8700
Mailing Address - Street 1:2390 E FLORIDA AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-4707
Mailing Address - Country:US
Mailing Address - Phone:951-658-7297
Mailing Address - Fax:951-925-6447
Practice Address - Street 1:2390 E FLORIDA AVE
Practice Address - Street 2:STE 101
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-4707
Practice Address - Country:US
Practice Address - Phone:951-658-7297
Practice Address - Fax:951-925-6447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APEX HEALTHCARE MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-27
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26672ZMedicare PIN