Healthcare Provider Details

I. General information

NPI: 1669799557
Provider Name (Legal Business Name): EDUARDO PASMAN JAVIER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67780 E PALM CANYON DR
CATHEDRAL CITY CA
92234-5441
US

IV. Provider business mailing address

67780 E PALM CANYON DR
CATHEDRAL CITY CA
92234-5441
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-4300
  • Fax: 760-837-8994
Mailing address:
  • Phone: 760-773-4300
  • Fax: 760-837-8994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA111036
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA111036
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberA111036
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: