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69175 Ramon Rd Bldg A Cathedral City CA 92234-3344 | |
(760) 323-2118 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 69175 Ramon Rd Bldg A, Cathedral City, California |
Authorized Official Name and Position | Judy Stith (CFO) |
Authorized Official Contact | 7609694516 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1695 N Sunrise Way Palm Springs CA 92262-3701 Ph: (760) 323-2118 | 69175 Ramon Rd Bldg A Cathedral City CA 92234-3344 Ph: (760) 323-2118 |
NPI Number | 1366127698 |
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Provider Enumeration Date | 06/15/2023 |
Last Update Date | 08/09/2024 |
Identifier | Type | State | Issuer |
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1366127698 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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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 | |