Healthcare Provider Details

I. General information

NPI: 1851828222
Provider Name (Legal Business Name): DESERT VALLEY OBGYN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR STE 303
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

18400 US HIGHWAY 18 STE A
APPLE VALLEY CA
92307-2306
US

V. Phone/Fax

Practice location:
  • Phone: 760-346-1133
  • Fax:
Mailing address:
  • Phone: 760-242-3939
  • Fax: 760-242-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PEDRAM ILBEIGI
Title or Position: DIRECTOR
Credential: M.D.
Phone: 760-515-6260