Healthcare Provider Details
I. General information
NPI: 1699960757
Provider Name (Legal Business Name): INDIO EMERGENCY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2007
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1293 6TH ST
COACHELLA CA
92236-1707
US
IV. Provider business mailing address
81767 DR CARREON BLVD SUITE#201
INDIO CA
92201-5526
US
V. Phone/Fax
- Phone: 760-391-5151
- Fax: 760-391-5159
- Phone: 760-775-4181
- Fax: 760-775-4818
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FRANK
A
CURRY
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 760-775-4181