Healthcare Provider Details

I. General information

NPI: 1275728198
Provider Name (Legal Business Name): DESERT MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35325 DATE PALM DR STE 239
CATHEDRAL CITY CA
92234-7015
US

IV. Provider business mailing address

35325 DATE PALM DR STE 239
CATHEDRAL CITY CA
92234-7015
US

V. Phone/Fax

Practice location:
  • Phone: 760-969-6560
  • Fax: 760-328-2230
Mailing address:
  • Phone: 760-969-6560
  • Fax: 760-328-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE BRANDON
Title or Position: CREDENTIALS MANAGER
Credential: CPCS
Phone: 760-320-4122