Southern California Primary Care Canyon Lake Urgent & Family Care
NPI 1710242474 · Non-Pharmacy Dispensing Site · Lake Elsinore, CA
Southern California Primary Care Canyon Lake Urgent & Family Care is a Non-Pharmacy Dispensing Site organization in Lake Elsinore, CA (NPI 1710242474).
Provider details
- NPI number
- 1710242474
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Vp Ops(858) 964-1506
- License
- A48943 (CA)
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Danesh Medical Group
Registry dates
- Enumerated
- 2012-07-09
- Last updated
- 2012-10-25
Frequently asked questions
- What is Southern California Primary Care Canyon Lake Urgent & Family Care's NPI number?
- Southern California Primary Care Canyon Lake Urgent & Family Care's National Provider Identifier (NPI) is 1710242474, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern California Primary Care Canyon Lake Urgent & Family Care?
- Southern California Primary Care Canyon Lake Urgent & Family Care is classified in the NPPES registry as Non-Pharmacy Dispensing Site (Suppliers).
- Where is Southern California Primary Care Canyon Lake Urgent & Family Care located?
- Southern California Primary Care Canyon Lake Urgent & Family Care's practice location on file with NPPES is 31581 Canyon Estates Dr, Lake Elsinore, CA 92532-0424.
- What is Southern California Primary Care Canyon Lake Urgent & Family Care's phone number?
- The practice phone number listed in the NPPES registry for Southern California Primary Care Canyon Lake Urgent & Family Care is (951) 244-3500.
- Who is the authorized official for Southern California Primary Care Canyon Lake Urgent & Family Care?
- The authorized official listed on Southern California Primary Care Canyon Lake Urgent & Family Care's NPPES record is Kenny Heine, Vp Ops. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern California Primary Care Canyon Lake Urgent & Family Care's NPI active?
- Yes — Southern California Primary Care Canyon Lake Urgent & Family Care's NPI (1710242474) is active in the NPPES registry as of the last update on 2012-10-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.