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General NPI Number Information
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NPI Number | 1700643186
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Entity Type | Organization
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Legal Business Name | SANJAY VERMA, MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 79200 CORPORATE CENTER DR STE 101
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City | LA QUINTA
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State | CA
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Zip | 92253-7245
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Country | US
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Telephone | 760-984-0003
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Fax | 442-300-2135
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Provider Business Mailing Address
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Address Line | 79125 CORPORATE CENTER DR UNIT 5157
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City | LA QUINTA
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State | CA
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Zip | 92248-4009
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Country | US
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Telephone | 760-984-0003
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Fax | 442-300-2135
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Authorized Official
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Title or Position | PRESIDENT / PHYSICIAN
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Name | DR. SANJAY VERMA
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Credential | MD
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Telephone | 760-984-0003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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