Provider Demographics
NPI:1295805679
Name:ASPREC, J M (MD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:M
Last Name:ASPREC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:MALIG
Other - Last Name:ASPREC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:31571 CANYON ESTATES DR STE 132
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-0471
Mailing Address - Country:US
Mailing Address - Phone:951-674-7811
Mailing Address - Fax:951-674-7812
Practice Address - Street 1:31571 CANYON ESTATES DR
Practice Address - Street 2:SUITE 225
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0471
Practice Address - Country:US
Practice Address - Phone:951-674-7811
Practice Address - Fax:951-674-7812
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A416911Medicaid
CA00A416910Medicare ID - Type UnspecifiedMEDICARE
CA00A416911Medicaid