| Edgar J Stanley Md Inc A Medical Corporation | |
|
1180 N Indian Canyon Dr Ste E425 Palm Springs CA 92262-4800 | |
| (760) 322-7900 | |
| (760) 322-7911 |
| Full Name | Edgar J Stanley Md Inc A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1180 N Indian Canyon Dr Ste E425, Palm Springs, California |
| Authorized Official Name and Position | Edgar Javier Stanley (PRESIDENT) |
| Authorized Official Contact | 7603227900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgar J Stanley Md Inc A Medical Corporation 1180 N Indian Canyon Dr Ste E425 Palm Springs CA 92262-4800 Ph: (760) 322-7900 | Edgar J Stanley Md Inc A Medical Corporation 1180 N Indian Canyon Dr Ste E425 Palm Springs CA 92262-4800 Ph: (760) 322-7900 |
| NPI Number | 1457667123 |
|---|---|
| Provider Enumeration Date | 08/19/2010 |
| Last Update Date | 12/27/2022 |
| Medicare PECOS PAC ID | 2961699236 |
|---|---|
| Medicare Enrollment ID | O20101213000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457667123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Edgar Stanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184688624 PECOS PAC ID: 3971590852 Enrollment ID: I20101213000665 |
| Provider Name | Paul Duncan Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699250886 PECOS PAC ID: 8426467036 Enrollment ID: I20210512000977 |
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