Healthcare Provider Details

I. General information

NPI: 1821664657
Provider Name (Legal Business Name): STACEY ELIZABETH HEINDL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date: 11/28/2022
Reactivation Date: 12/07/2022

III. Provider practice location address

1150 N INDIAN CANYON DR
PALM SPRINGS CA
92262-4872
US

IV. Provider business mailing address

555 E TACHEVAH DR
PALM SPRINGS CA
92262-5750
US

V. Phone/Fax

Practice location:
  • Phone: 760-323-6511
  • Fax:
Mailing address:
  • Phone: 760-434-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA194861
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: