| High Desert Family Medical Clinic | |
|
7350 Church St Yucca Valley CA 92284-3246 | |
| (760) 369-3069 | |
| (760) 369-3072 |
| Full Name | High Desert Family Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 7350 Church St, Yucca Valley, California |
| Authorized Official Name and Position | Andre M Kasko (PRESIDENT) |
| Authorized Official Contact | 7603693069 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Desert Family Medical Clinic Po Box 1220 Joshua Tree CA 92252-0810 Ph: (760) 369-3069 | High Desert Family Medical Clinic 7350 Church St Yucca Valley CA 92284-3246 Ph: (760) 369-3069 |
| NPI Number | 1639405004 |
|---|---|
| Provider Enumeration Date | 10/20/2009 |
| Last Update Date | 10/20/2009 |
| Medicare PECOS PAC ID | 0648346007 |
|---|---|
| Medicare Enrollment ID | O20091210000140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639405004 | NPI | - | NPPES |
| 553845 | Other | CA | MEDICARE IDENTIFICATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A6300 (California) | Primary |
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