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41990 Cook St Suite F1001 Palm Desert CA 92211-6100 | |
(760) 360-2502 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 41990 Cook St, Palm Desert, California |
Authorized Official Name and Position | Bum Song (MANAGER) |
Authorized Official Contact | 7605748080 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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41990 Cook St Suite F1001 Palm Desert CA 92211-6100 Ph: (760) 360-2502 | 41990 Cook St Suite F1001 Palm Desert CA 92211-6100 Ph: (760) 360-2502 |
NPI Number | 1003091091 |
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Provider Enumeration Date | 01/08/2008 |
Last Update Date | 03/22/2013 |
Medicare PECOS PAC ID | 5294895447 |
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Medicare Enrollment ID | O20081118000914 |
Identifier | Type | State | Issuer |
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1003091091 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | A68018 (California) | Primary |
Provider Name | Hyun Myung Jim Cho |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1073658530 PECOS PAC ID: 4385704535 Enrollment ID: I20081118000913 |
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