Healthcare Provider Details

I. General information

NPI: 1568197408
Provider Name (Legal Business Name): HEALTH SERVICE ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41990 COOK ST # F-2002
PALM DESERT CA
92211-6100
US

IV. Provider business mailing address

41990 COOK ST # F-2002
PALM DESERT CA
92211-6100
US

V. Phone/Fax

Practice location:
  • Phone: 442-334-7192
  • Fax: 760-565-7707
Mailing address:
  • Phone: 760-674-7132
  • Fax: 760-674-7120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY J COX
Title or Position: CFO
Credential:
Phone: 909-464-9675