MEDICARE: DESERT WELLNESS NON MEDICAL GROUP LLC

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1467394825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT WELLNESS NON MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	600 W BROADWAY
Second Line	:	700-100A PMB 70224
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-3311
Country	:	US
Telephone Number	:	442-230-6492
Fax Number	:	760-406-5993

Provider Business Practice Location Address
First Line	:	2390 N TRAIL CIR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-3132
Country	:	US
Telephone Number	:	916-716-2562
Fax Number	:	760-406-5993

Authorized Official
Title or Position	:	CEO
Name	:	DONALD RAYMOND HIERS
Credential	:	CMA
Telephone Number	:	442-230-6492

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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