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General NPI Number Information
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NPI Number | 1851726228
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Entity Type | Organization
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Legal Business Name | MERIT HEALTHCARE INC.
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 777 E TAHQUITZ CANYON WAY 200-093
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6784
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Country | US
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Telephone | 760-242-6561
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Fax | 760-242-1354
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Provider Business Mailing Address
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Address Line | 777 E TAHQUITZ CANYON WAY 200-093
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6784
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Country | US
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Telephone | 760-242-6561
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Fax | 760-242-1354
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW S KOZLOFF
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Credential | MD
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Telephone | 760-242-6561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C55616
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License Number State | CA
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