Healthcare Provider Details

I. General information

NPI: 1578100103
Provider Name (Legal Business Name): DONALD RAYMOND HIERS CMA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 N TRAIL CIR
PALM SPRINGS CA
92262-3132
US

IV. Provider business mailing address

600 WEST BROADWAY 700-100A PMB 70224
SAN DIEGO CA
92101-3113
US

V. Phone/Fax

Practice location:
  • Phone: 442-230-6492
  • Fax: 760-406-5993
Mailing address:
  • Phone: 442-230-6492
  • Fax: 760-406-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: