Healthcare Provider Details

I. General information

NPI: 1992915839
Provider Name (Legal Business Name): NOREEN BUMBY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NOREEN ANNE BUMBY D.O.

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72171 HIGHWAY 111 SUITE 204
PALM DESERT CA
92260-4219
US

IV. Provider business mailing address

72171 HIGHWAY 111 SUITE 204
PALM DESERT CA
92260-4219
US

V. Phone/Fax

Practice location:
  • Phone: 760-776-4665
  • Fax: 760-776-4652
Mailing address:
  • Phone: 760-776-4665
  • Fax: 760-776-4652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number020A6441
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number020A6441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: