Healthcare Provider Details

I. General information

NPI: 1922336114
Provider Name (Legal Business Name): WENDY WHITE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2009
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR STE K-114
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-321-5257
  • Fax: 760-773-1361
Mailing address:
  • Phone: 760-321-5257
  • Fax: 760-773-1361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA110153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: