MEDICARE: HIGH DESERT BUSINESS ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	A74120	CA

General Provider Information

NPI Number	:	1285957043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGH DESERT BUSINESS ASSOCIATES INC

Provider Business Mailing Address
First Line	:	17868 US HIGHWAY 18
Second Line	:	#211
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-1267
Country	:	US
Telephone Number	:	760-946-8870
Fax Number	:	760-946-8818

Provider Business Practice Location Address
First Line	:	17868 US HIGHWAY 18
Second Line	:	#211
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-1267
Country	:	US
Telephone Number	:	760-810-0992
Fax Number	:	760-810-0993

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANNY COLTON
Credential	:	MD
Telephone Number	:	760-946-8870

Provider Enumeration Date	:	03/09/2010
Last Update Date	:	04/14/2011

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