Healthcare Provider Details

I. General information

NPI: 1356777890
Provider Name (Legal Business Name): DESERT MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57840 29 PALMS HWY A
YUCCA VALLEY CA
92284-3047
US

IV. Provider business mailing address

275 N EL CIELO RD
PALM SPRINGS CA
92262-6972
US

V. Phone/Fax

Practice location:
  • Phone: 760-323-8657
  • Fax: 760-318-9083
Mailing address:
  • Phone: 760-323-8657
  • Fax: 760-318-9083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HELENE LECLAIR
Title or Position: VP NETWORK ADMINISTRATION
Credential:
Phone: 760-323-8657