Healthcare Provider Details

I. General information

NPI: 1114624665
Provider Name (Legal Business Name): EISENHOWER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81719 DR CARREON BLVD STE B
INDIO CA
92201-5518
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3202
US

V. Phone/Fax

Practice location:
  • Phone: 760-837-8722
  • Fax: 760-834-7989
Mailing address:
  • Phone: 760-837-8722
  • Fax: 760-834-7989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARTIN JOSEPH MASSIELLO
Title or Position: PRESIDENT/CEO
Credential:
Phone: 760-773-1228