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General NPI Number Information
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NPI Number | 1336930262
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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 | 05/12/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1111 E TAHQUITZ CANYON WAY STE 120
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City | PALM SPRINGS
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State | CA
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Zip | 92262-0116
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Country | US
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Telephone | 760-837-8366
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Fax | 760-837-8367
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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 & 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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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