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General NPI Number Information
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NPI Number | 1861636144
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Entity Type | Organization
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Legal Business Name | SAN CROSS MEDICAL
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 14080 PALM DR SUTIE D-506
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City | DESERT HOT SPRINGS
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State | CA
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Zip | 92240-6851
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Country | US
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Telephone | 760-880-6870
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Fax |
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Provider Business Mailing Address
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Address Line | 14080 PALM DR SUTIE D-506
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City | DESERT HOT SPRINGS
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State | CA
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Zip | 92240-6851
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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 | CEO
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Name | JEFFREY L HENDEL
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Credential | MD
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Telephone | 760-880-6870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G57286
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License Number State | CA
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