Healthcare Provider Details

I. General information

NPI: 1285660233
Provider Name (Legal Business Name): JENNIFER ALONZO DOWALTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER A DOWALTER MD

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

39000 BOB HOPE DRIVE
RANCHO MIRAGE CA
92270
US

V. Phone/Fax

Practice location:
  • Phone: 760-837-8905
  • Fax: 760-837-8905
Mailing address:
  • Phone: 760-837-8905
  • Fax: 760-837-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA96391
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA96391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: