Healthcare Provider Details

I. General information

NPI: 1033759311
Provider Name (Legal Business Name): DAP HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8881 FLETCHER PKWY STE 200
LA MESA CA
91942-3135
US

IV. Provider business mailing address

1695 N. SUNRISE WAY
PALMS SPRINGS CA
92262
US

V. Phone/Fax

Practice location:
  • Phone: 619-464-6434
  • Fax: 619-464-5109
Mailing address:
  • Phone: 760-323-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: JUDY STITH
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 760-323-2118