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General NPI Number Information
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NPI Number | 1942516737
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Entity Type | Organization
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Legal Business Name | B. MAYA KATO, MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 36867 COOK ST SUITE 103
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City | PALM DESERT
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State | CA
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Zip | 92211-6064
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Country | US
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Telephone | 760-565-3900
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Fax | 855-505-3900
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Provider Business Mailing Address
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Address Line | 36867 COOK ST SUITE 103
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City | PALM DESERT
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State | CA
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Zip | 92211-6064
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Country | US
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Telephone | 760-565-3900
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Fax | 855-505-3900
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Authorized Official
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Title or Position | PRESIDENT
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Name | BLYTHE MAYA KATO
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Credential | M.D.
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Telephone | 760-565-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G86538
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License Number State | CA
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