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General NPI Number Information
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NPI Number | 1023215308
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Entity Type | Organization
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Legal Business Name | DESERT FAMILY CARE
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 81713 HIGHWAY 111 SUITE F
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City | INDIO
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State | CA
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Zip | 92201-0000
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Country | US
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Telephone | 760-863-5355
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Fax | 760-863-5885
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Provider Business Mailing Address
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Address Line | 81713 HIGHWAY 111 SUITE F
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City | INDIO
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State | CA
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Zip | 92201-0000
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Country | US
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Telephone | 760-863-5355
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Fax | 760-863-5885
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Authorized Official
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Title or Position | NP
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Name | MR. JOB LOPEZ
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Credential | NP
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Telephone | 760-863-5355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP9223
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License Number State | CA
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