Healthcare Provider Details

I. General information

NPI: 1194158667
Provider Name (Legal Business Name): DR. ASHLY MAUGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4791 E PALM CANYON DR
PALM SPRINGS CA
92264-5220
US

IV. Provider business mailing address

4791 E PALM CANYON DR
PALM SPRINGS CA
92264-5220
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-7950
  • Fax: 760-834-7951
Mailing address:
  • Phone: 760-834-7950
  • Fax: 760-834-7951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC208613
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberC208613
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: