Healthcare Provider Details

I. General information

NPI: 1730024886
Provider Name (Legal Business Name): PRECIOUS KORTU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US

IV. Provider business mailing address

5300 S PRIEST DR
TEMPE AZ
85283-1568
US

V. Phone/Fax

Practice location:
  • Phone: 760-299-5181
  • Fax:
Mailing address:
  • Phone: 347-223-6176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: