| Kondovski Medical Group | |
|
79440 Corporate Center Dr. Ste 110 La Quinta CA 92253-7241 | |
| (760) 565-6969 | |
| (760) 565-6966 |
| Full Name | Kondovski Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 79440 Corporate Center Dr. Ste 110, La Quinta, California |
| Authorized Official Name and Position | Sacho Rade Kondovski (OWNER) |
| Authorized Official Contact | 7605656969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kondovski Medical Group 79440 Corporate Center Dr. Ste 110 La Quinta CA 92253-7241 Ph: (760) 565-6969 | Kondovski Medical Group 79440 Corporate Center Dr. Ste 110 La Quinta CA 92253-7241 Ph: (760) 565-6969 |
| NPI Number | 1184933699 |
|---|---|
| Provider Enumeration Date | 09/30/2010 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184933699 | NPI | - | NPPES |
| 020A60770 | Other | CA | MEDICARE ID - TYPE UNSPECIFIED |
| 20A6077 | Other | CA | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A6077 (California) | Primary |
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