Healthcare Provider Details

I. General information

NPI: 1831783620
Provider Name (Legal Business Name): DAP HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CIVIC CENTER DR STE A
VISTA CA
92083-5208
US

IV. Provider business mailing address

1695 N. SUNRISE WAY
PALM SPRINGS CA
92262
US

V. Phone/Fax

Practice location:
  • Phone: 760-493-4839
  • Fax: 760-439-4841
Mailing address:
  • Phone: 760-323-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 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