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General NPI Number Information
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NPI Number | 1760550701
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Entity Type | Organization
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Legal Business Name | DATE PALM INC.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 604 E HOBSONWAY
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City | BLYTHE
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State | CA
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Zip | 92225-1739
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Country | US
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Telephone | 760-922-3644
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Fax | 760-922-2671
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Provider Business Mailing Address
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Address Line | 604 E HOBSONWAY
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City | BLYTHE
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State | CA
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Zip | 92225-1739
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Country | US
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Telephone | 760-922-3644
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Fax | 760-922-2671
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Authorized Official
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Title or Position | OFFICER
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Name | DR. WALTER T. SPELSBERG
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Credential | M.D.
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Telephone | 760-922-3644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C22232
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C22232
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License Number State | CA
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