Healthcare Provider Details

I. General information

NPI: 1063488872
Provider Name (Legal Business Name): JANET K IHDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DR STE E150 SUITE 225
PALM SPRINGS CA
92262-4835
US

IV. Provider business mailing address

PO BOX 2131
PALM SPRINGS CA
92263-2131
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-4915
  • Fax: 760-416-4916
Mailing address:
  • Phone: 760-416-4915
  • Fax: 760-416-4916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number33-0871544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: