Healthcare Provider Details
I. General information
NPI: 1891949467
Provider Name (Legal Business Name): R.A. BATTIE M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2008
Last Update Date: 11/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
73730 HIGHWAY 111 SUITE 1
PALM DESERT CA
92260-4018
US
IV. Provider business mailing address
73730 HIGHWAY 111 SUITE 1
PALM DESERT CA
92260-4018
US
V. Phone/Fax
- Phone: 760-568-1000
- Fax: 760-568-6889
- Phone: 760-568-1000
- Fax: 760-568-6889
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QB0002X |
| Taxonomy | Obesity Medicine (Family Medicine) Physician |
| License Number | A23910 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
RAYMOND
BATTIE
Title or Position: OWNER
Credential: M.D.
Phone: 760-568-1000