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NPI 1790297174

NPI 1790297174 : SARAH MCINTOSH : RANCHO MIRAGE, CA

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General NPI Number Information
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    NPI Number           |    1790297174
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH MCINTOSH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/25/2017
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    Last Update Date     |    10/25/2017
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Provider Practice Location Address
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    Address Line         |    72027 HIGHWAY 111 
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    City                 |    RANCHO MIRAGE
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    State                |    CA
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    Zip                  |    92270-4961
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    Country              |    US
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    Telephone            |    760-323-3909
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    35761 RAPHAEL DR 
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    City                 |    PALM DESERT
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    State                |    CA
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    Zip                  |    92211-4505
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    95006788
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    License Number State |    CA
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