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General NPI Number Information
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NPI Number | 1548354038
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Entity Type | Organization
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Legal Business Name | INDIO SURGERY CENTER
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 46900 MONROE ST. #B201
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City | INDIO
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State | CA
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Zip | 92201
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Country | US
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Telephone | 760-396-5733
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Fax |
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Provider Business Mailing Address
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Address Line | 46900 MONROE ST STE B201
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City | INDIO
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State | CA
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Zip | 92201-4828
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Country | US
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Telephone | 760-396-5733
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Fax | 760-396-5723
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Authorized Official
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Title or Position | OWNER
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Name | MS. DIANA K JESSON
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Credential | RN
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Telephone | 760-396-5733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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