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Southern California Primary Care Canyon Lake Urgent & Family Care

Non-Pharmacy Dispensing Site in Lake Elsinore, CA · enumerated 2012 · authorized official Kenny Heine, Vp Ops.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1710242474

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Registry record

Entity type Organization (Type 2)
Legal business name Southern California Primary Care Canyon Lake Urgent & Family Care
Other name <Unavail>
Parent organization Medvantx, Inc.
Practice address 31581 Canyon Estates Dr, Lake Elsinore, CA, 92532
Phone (951) 244-3500
Enumeration date Jul 9, 2012
Last updated in NPPES Oct 25, 2012

Taxonomy & classification

332900000X Non-Pharmacy Dispensing Site Suppliers · License A48943 (CA) Primary

Authorized official

Name Kenny Heine
Title Vp Ops
Phone (858) 964-1506

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Southern California Primary Care Canyon Lake Urgent & Family Care?
The NPI for Southern California Primary Care Canyon Lake Urgent & Family Care is 1710242474, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Southern California Primary Care Canyon Lake Urgent & Family Care?
NPPES lists Kenny Heine (Vp Ops) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-10-25.