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General NPI Number Information
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NPI Number | 1922204890
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Entity Type | Organization
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Legal Business Name | DESERT NEPHROLOGY
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 1180 N INDIAN CANYON DR STE W303
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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 | 760-416-4819
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Fax | 760-416-4829
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Provider Business Mailing Address
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Address Line | 1180 N INDIAN CANYON W 303
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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 | 760-416-4819
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Fax | 760-416-4829
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. BRYAN L STONE
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Credential | M.D.
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Telephone | 760-416-4819
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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 | G80187
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License Number State | CA
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