Healthcare Provider Details

I. General information

NPI: 1386016087
Provider Name (Legal Business Name): DESERT CITIES ANESTHESIA PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DR SUITE 110
PALM SPRINGS CA
92262-4800
US

IV. Provider business mailing address

777 E TAHQUITZ CANYON WAY SUITE 200-81
PALM SPRINGS CA
92262-6784
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-4600
  • Fax:
Mailing address:
  • Phone: 562-407-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH ELISHA
Title or Position: PRESIDENT
Credential: MD
Phone: 760-275-6207