| |
41990 Cook St Bldg J Suite 901 Palm Desert CA 92211-6100 | |
(760) 341-6262 | |
(760) 341-6226 |
Full Name | |
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Speciality | Family Medicine |
Location | 41990 Cook St Bldg J, Palm Desert, California |
Authorized Official Name and Position | John N Taylor (OWNER) |
Authorized Official Contact | 7603416262 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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41990 Cook St Bldg J Suite 901 Palm Desert CA 92211-6100 Ph: (760) 341-6262 | 41990 Cook St Bldg J Suite 901 Palm Desert CA 92211-6100 Ph: (760) 341-6262 |
NPI Number | 1154478790 |
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Provider Enumeration Date | 01/05/2007 |
Last Update Date | 12/02/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154478790 | NPI | - | NPPES |
A90426 | Other | CA | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A90426 (California) | Primary |
Faculty Physicians And Surgeons Of Llusm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41865 Boardwalk, Suite 103, Palm Desert, CA 92211 Phone: 760-341-5570 Fax: 909-558-3905 | |
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