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General NPI Number Information
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NPI Number | 1225839871
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Entity Type | Organization
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Legal Business Name | DESERT INTEGRATIVE HEALTH LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 2235 E FLAMINGO RD STE 220
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City | LAS VEGAS
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State | NV
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Zip | 89119-0807
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Country | US
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Telephone | 702-493-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 2235 E FLAMINGO RD STE 220
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City | LAS VEGAS
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State | NV
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Zip | 89119-0807
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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 | HR
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Name | DIVINA CARLSON-ROSS
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Credential |
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Telephone | 949-300-0010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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