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General NPI Number Information
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NPI Number | 1073747994
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Entity Type | Organization
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Legal Business Name | PALMS MEDICAL CLINIC
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 09/08/2009
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Provider Practice Location Address
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Address Line | 611 S PALM CANYON DR SUITE 7464
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City | PALM SPRINGS
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State | CA
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Zip | 92264-7453
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Country | US
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Telephone | 760-880-6862
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Fax |
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Provider Business Mailing Address
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Address Line | 611 S PALM CANYON DR SUITE 7464
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City | PALM SPRINGS
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State | CA
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Zip | 92264-7453
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EUGENE C GROEGER
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Credential | MD
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Telephone | 760-880-6862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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