Healthcare Provider Details

I. General information

NPI: 1356770515
Provider Name (Legal Business Name): NATALIE DRIESSEN, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44311 MONTEREY AVE
PALM DESERT CA
92260-2710
US

IV. Provider business mailing address

44311 MONTEREY AVE
PALM DESERT CA
92260-2710
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-6616
  • Fax: 760-773-6618
Mailing address:
  • Phone: 760-773-6616
  • Fax: 760-773-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA106037
License Number StateCA

VIII. Authorized Official

Name: DR. NATALIE DRIESSEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-212-3413