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General NPI Number Information
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NPI Number | 1063743490
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Entity Type | Organization
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Legal Business Name | EISENHOWER MEDICAL CENTER
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 45280 SEELEY DR
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City | LA QUINTA
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State | CA
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Zip | 92253-6834
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Country | US
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Telephone | 760-610-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 39000 BOB HOPE DR
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-3221
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Country | US
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Telephone | 760-340-3911
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MARTIN MASSIELLO
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Credential |
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Telephone | 760-340-3911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 250000142
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License Number State | CA
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