| |
1801 E Tahquitz Canyon Way Ste 200, Palm Springs, CA 92262-7123 | |
(760) 327-2700 | |
(760) 327-2799 |
Full Name | |
---|---|
Type | Facility |
Speciality | Specialist |
Location | 1801 E Tahquitz Canyon Way Ste 200, Palm Springs, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164977336 | NPI | - | NPPES |
1114205432 | Medicaid | CA | |
FQ161B | Other | CA | MCR(N) |
FQ161A | Other | CA | MCR(S) |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (California) | Secondary |
174400000X | Specialist | (California) | Primary |
207W00000X | Ophthalmology | (California) | Secondary |
Mailing Address | Practice Location Address |
---|---|
100 E California Blvd, Pasadena, CA 91105-3205 Ph: (888) 884-3805 | 1801 E Tahquitz Canyon Way Ste 200, Palm Springs, CA 92262-7123 Ph: (760) 327-2700 |