Healthcare Provider Details

I. General information

NPI: 1477968360
Provider Name (Legal Business Name): ARBATEL DE LA CUESTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 09/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72780 COUNTRY CLUB DRIVE BLDG. B SUITE 205B
RANCHO MIRAGE CA
92270
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-7900
  • Fax: 760-834-7901
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA140147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: