Provider Demographics
NPI:1841095908
Name:TEMECULA FAMILY MEDICAL CLINIC
Entity type:Organization
Organization Name:TEMECULA FAMILY MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANISI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:951-676-9666
Mailing Address - Street 1:27625 JEFFERSON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2619
Mailing Address - Country:US
Mailing Address - Phone:951-676-9666
Mailing Address - Fax:951-676-5947
Practice Address - Street 1:27625 JEFFERSON AVE STE 101
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2619
Practice Address - Country:US
Practice Address - Phone:951-676-9666
Practice Address - Fax:951-676-5947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty