Healthcare Provider Details

I. General information

NPI: 1285957043
Provider Name (Legal Business Name): HIGH DESERT BUSINESS ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17868 US HIGHWAY 18 #211
APPLE VALLEY CA
92307-1267
US

IV. Provider business mailing address

17868 US HIGHWAY 18 #211
APPLE VALLEY CA
92307-1267
US

V. Phone/Fax

Practice location:
  • Phone: 760-810-0992
  • Fax: 760-810-0993
Mailing address:
  • Phone: 760-946-8870
  • Fax: 760-946-8818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA74120
License Number StateCA

VIII. Authorized Official

Name: DR. DANNY COLTON
Title or Position: PRESIDENT
Credential: MD
Phone: 760-946-8870