| Advantage Sports And Wellness Medical Center | |
|
78120 Wildcat Dr Palm Desert CA 92211-1140 | |
| (760) 360-1433 | |
| (760) 360-5092 |
| Full Name | Advantage Sports And Wellness Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 78120 Wildcat Dr, Palm Desert, California |
| Authorized Official Name and Position | Stephen R Steele (PRESIDENT) |
| Authorized Official Contact | 7603601433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Sports And Wellness Medical Center 78120 Wildcat Dr Palm Desert CA 92211-1140 Ph: (760) 360-1433 | Advantage Sports And Wellness Medical Center 78120 Wildcat Dr Palm Desert CA 92211-1140 Ph: (760) 360-1433 |
| NPI Number | 1902015498 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 11/20/2008 |
| Medicare PECOS PAC ID | 4486741956 |
|---|---|
| Medicare Enrollment ID | O20071107000846 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902015498 | NPI | - | NPPES |
| 1285632604 | Other | TYPE 1 NPI NUMBER | |
| 20A555 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 20A555 (California) | Primary |
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