Healthcare Provider Details

I. General information

NPI: 1316833387
Provider Name (Legal Business Name): FMK HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72960 FRED WARING DR STE 101
PALM DESERT CA
92260-2897
US

IV. Provider business mailing address

72960 FRED WARING DR STE 101
PALM DESERT CA
92260-2897
US

V. Phone/Fax

Practice location:
  • Phone: 760-641-4085
  • Fax: 877-285-0477
Mailing address:
  • Phone: 760-641-4085
  • Fax: 877-285-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JANICE COMPTON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 830-832-9703