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General NPI Number Information
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NPI Number | 1558521963
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Entity Type | Organization
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Legal Business Name | DESERT MEDICAL ADVANCES DMA OF THE COACHELLA VALLEY MEDICAL CORPORATIO
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 69730 HIGHWAY 111 STE 101
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-2873
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Country | US
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Telephone | 760-341-9638
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Fax | 760-341-9872
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Provider Business Mailing Address
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Address Line | 69730 HIGHWAY 111 STE 101
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-2873
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Country | US
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Telephone | 760-341-9638
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Fax | 760-341-9872
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. MARIA GREENWALD
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Credential | M.D.
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Telephone | 760-341-9638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G49422
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License Number State | CA
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