Basic Information
Provider Information
NPI: 1114239068
EntityType: 2
ReplacementNPI:  
OrganizationName: KPC GLOBAL MEDICAL CENTERS, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: HEMET GLOBAL MEDICAL CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1117 E DEVONSHIRE AVE
Address2:  
City: HEMET
State: CA
PostalCode: 925433083
CountryCode: US
TelephoneNumber: 9516522811
FaxNumber: 9517654782
Practice Location
Address1: 1117 E DEVONSHIRE AVE
Address2:  
City: HEMET
State: CA
PostalCode: 925433083
CountryCode: US
TelephoneNumber: 9516522811
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/08/2010
LastUpdateDate: 05/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: COLLINS
AuthorizedOfficialFirstName: JOHN
AuthorizedOfficialMiddleName: R
AuthorizedOfficialTitleorPosition: OFFICER
AuthorizedOfficialTelephone: 7149534531
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


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