Healthcare Provider Details
I. General information
NPI: 1972777043
Provider Name (Legal Business Name): TOTAL HEALTH OF THE DESERT A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2008
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 N PALM CANYON DR STE 205
PALM SPRINGS CA
92262-4426
US
IV. Provider business mailing address
1100 N PALM CANYON DR STE 205
PALM SPRINGS CA
92262-4426
US
V. Phone/Fax
- Phone: 760-323-4296
- Fax: 760-320-9445
- Phone: 760-323-4296
- Fax: 760-320-9445
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | C51805 |
| License Number State | CA |
VIII. Authorized Official
Name:
GHALEB
S
SAABBAH
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 760-323-4296