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General NPI Number Information
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NPI Number | 1821951351
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Entity Type | Organization
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Legal Business Name | DESERT ELITE EYE GROUP INC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1180 NORTH INDIAN CANYON DRIVE SUITE E130
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City | PALM SPRINGS
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State | CA
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Zip | 92262
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Country | US
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Telephone | 760-776-8600
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Fax | 760-776-8400
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Provider Business Mailing Address
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Address Line | 45175 PANORAMA DR STE B
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City | PALM DESERT
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State | CA
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Zip | 92260-4482
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Country | US
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Telephone | 760-776-8600
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Fax | 760-776-8400
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WALLACE FRANKLIN GOLDBAN
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Credential |
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Telephone | 760-320-8497
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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 |
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License Number State |
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