Archis Desai Md Inc. | |
1030 Nevada St Ste 101 Redlands CA 92374-2957 | |
(909) 966-5500 | |
(909) 966-5222 |
Full Name | Archis Desai Md Inc. |
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Speciality | Internal Medicine |
Location | 1030 Nevada St Ste 101, Redlands, California |
Authorized Official Name and Position | Archis D Desai (MEDICAL DOCTOR) |
Authorized Official Contact | 9099665500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Archis Desai Md Inc. 1030 Nevada St Ste 101 Redlands CA 92374-2957 Ph: (909) 966-5500 | Archis Desai Md Inc. 1030 Nevada St Ste 101 Redlands CA 92374-2957 Ph: (909) 966-5500 |
NPI Number | 1639696412 |
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Provider Enumeration Date | 08/23/2017 |
Last Update Date | 08/17/2021 |
Medicare PECOS PAC ID | 0345501060 |
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Medicare Enrollment ID | O20180419001068 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639696412 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Ralph P Lissaur |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1245287960 PECOS PAC ID: 1557318870 Enrollment ID: I20050407000879 |
Provider Name | David P Desai |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1740451566 PECOS PAC ID: 2961696885 Enrollment ID: I20101104000167 |
Provider Name | Uchenna G Orji |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457770836 PECOS PAC ID: 8325004880 Enrollment ID: I20150617002610 |
Provider Name | Archis D Desai |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396141230 PECOS PAC ID: 8224301312 Enrollment ID: I20180524001109 |
Provider Name | Arnon David Desai |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619339991 PECOS PAC ID: 0345534863 Enrollment ID: I20190918000644 |
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