Healthcare Provider Details

I. General information

NPI: 1538084868
Provider Name (Legal Business Name): NAOMI GEORGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41550 ECLECTIC ST
PALM DESERT CA
92260-1967
US

IV. Provider business mailing address

5558 OLD FIELD RD
LONG GROVE IL
60047-5211
US

V. Phone/Fax

Practice location:
  • Phone: 760-299-5181
  • Fax:
Mailing address:
  • Phone: 847-800-6392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: