Healthcare Provider Details
I. General information
NPI: 1346961968
Provider Name (Legal Business Name): INFINITY HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2022
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36915 COOK STREET STE 103
PALM DESERT CA
92211
US
IV. Provider business mailing address
36915 COOK STREET STE 103
PALM DESERT CA
92211
US
V. Phone/Fax
- Phone: 760-641-7217
- Fax: 760-406-5636
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SANA
KHAN
Title or Position: CEO
Credential: D.O.
Phone: 760-641-7217