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General NPI Number Information
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NPI Number | 1801925367
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Entity Type | Organization
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Legal Business Name | WESTERN HORIZON MEDICAL GROUP
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 35900 BOB HOPE DR SUITE # 205
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1766
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Country | US
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Telephone | 760-324-5044
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Fax | 760-251-9592
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Provider Business Mailing Address
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Address Line | 255 N EL CIELO RD SUITE # 604
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6974
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Country | US
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Telephone | 760-251-3401
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Fax | 760-251-9592
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RICHARD KYAW
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Credential | M.D.
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Telephone | 760-251-3401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A44805
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License Number State | CA
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