Healthcare Provider Details

I. General information

NPI: 1497375992
Provider Name (Legal Business Name): JOEL TODD MCCOY NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 07/06/2025
Certification Date: 07/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66675 PIERSON BLVD
DESERT HOT SPRINGS CA
92240-3737
US

IV. Provider business mailing address

1395 E GRANVIA VALMONTE
PALM SPRINGS CA
92262-6107
US

V. Phone/Fax

Practice location:
  • Phone: 408-505-0260
  • Fax:
Mailing address:
  • Phone: 408-505-0260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95013459
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95013459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: