Healthcare Provider Details

I. General information

NPI: 1255490819
Provider Name (Legal Business Name): DAP HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88775 AVENUE 76 STE. 1
THERMAL CA
92274
US

IV. Provider business mailing address

1695 N. SUNRISE WAY
PALM SPRINGS CA
92262
US

V. Phone/Fax

Practice location:
  • Phone: 760-397-2501
  • Fax: 760-397-2508
Mailing address:
  • Phone: 760-323-2118
  • Fax: 858-634-6901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: JUDY STITH
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 760-323-2118