Healthcare Provider Details

I. General information

NPI: 1831682749
Provider Name (Legal Business Name): IRENE M HUTCHINS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DR STE E218
PALM SPRINGS CA
92262-4885
US

IV. Provider business mailing address

PO BOX 1223
PALM SPRINGS CA
92263-1223
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA128482
License Number StateCA

VIII. Authorized Official

Name: DR. IRENE M HUTCHINS
Title or Position: OWNER
Credential: MD
Phone: 415-847-5008