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69175 Ramon Rd Building A Cathedral City CA 92234-3344 | |
(760) 321-6776 | |
(760) 321-4036 |
Full Name | |
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Speciality | Clinic/Center |
Location | 69175 Ramon Rd, Cathedral City, California |
Authorized Official Name and Position | Judy Stith (CHIEF ADMINISTRATIVE OFFICER) |
Authorized Official Contact | 7603232118 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1695 N. Sunrise Way Palm Springs CA 92262 Ph: (760) 323-2118 | 69175 Ramon Rd Building A Cathedral City CA 92234-3344 Ph: (760) 321-6776 |
NPI Number | 1619036514 |
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Provider Enumeration Date | 12/06/2006 |
Last Update Date | 03/07/2024 |
Medicare PECOS PAC ID | 6002989522 |
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Medicare Enrollment ID | O20240329001527 |
Identifier | Type | State | Issuer |
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1619036514 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 080000651 (California) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Vivien Pacold, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 68100 Ramon Rd, C-5, Cathedral City, CA 92234 Phone: 760-321-6068 Fax: 760-770-6789 | |