Healthcare Provider Details

I. General information

NPI: 1952163370
Provider Name (Legal Business Name): EISENHOWER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 E TAHQUITZ CANYON WAY
PALM SPRINGS CA
92262-6822
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-4394
  • Fax: 760-773-4382
Mailing address:
  • Phone: 760-773-1451
  • Fax: 760-773-1239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT JAMES FITZGERALD
Title or Position: VICE PRESIDENT
Credential:
Phone: 760-773-1451