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General NPI Number Information
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NPI Number | 1952474058
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Entity Type | Individual
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Provider Name | PRISCILLA ANNE SLAGLE MD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 946 N AVENIDA PALOS VERDES
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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 | 760-323-4259
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Fax | 760-322-7608
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Provider Business Mailing Address
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Address Line | 946 N AVENIDA PALOS VERDES
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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 | 760-323-4259
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Fax | 760-322-7608
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G15206
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | G15206
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License Number State | CA
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