Healthcare Provider Details

I. General information

NPI: 1710806898
Provider Name (Legal Business Name): HEALTHTEGRA MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81880 DR CARREON BLVD STE B207
INDIO CA
92201-5585
US

IV. Provider business mailing address

81880 DR CARREON BLVD STE B207
INDIO CA
92201-5585
US

V. Phone/Fax

Practice location:
  • Phone: 214-111-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX DAVID
Title or Position: MANAGER
Credential:
Phone: 214-000-1111