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General NPI Number Information
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NPI Number | 1679754378
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Entity Type | Organization
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Legal Business Name | CENTER FOR ADVANCED PULMONARY MEDICINE
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 71511 HIGHWAY 111 STE J
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4465
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Country | US
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Telephone | 760-674-9800
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Fax | 760-674-9807
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Provider Business Mailing Address
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Address Line | 18 CORNELL DR
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-3630
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Country | US
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Telephone | 562-208-2429
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Fax | 760-674-9807
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEARNED R GONZALES
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Credential | M.D.
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Telephone | 562-208-2429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A76930
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A76930
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License Number State | CA
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