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General NPI Number Information
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NPI Number | 1992014799
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Entity Type | Organization
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Legal Business Name | COLLEGE OF THE DESERT
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 43500 MONTEREY AVE
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City | PALM DESERT
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State | CA
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Zip | 92260-9305
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Country | US
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Telephone | 760-776-7385
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Fax |
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Provider Business Mailing Address
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Address Line | 43500 MONTEREY AVE
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City | PALM DESERT
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State | CA
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Zip | 92260-9305
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Country | US
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Telephone | 760-776-7385
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF STUDENT HEALTH
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Name | DR. NATHAN CHURCH
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Credential | PHD
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Telephone | 760-776-7385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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