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6380 Split Rock Ave Ste 29 Palms CA 92277-2550 | |
(760) 365-9305 | |
(866) 732-0113 |
Full Name | |
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Speciality | Clinic/Center |
Location | 6380 Split Rock Ave Ste, 29 Palms, California |
Authorized Official Name and Position | Cindy Schmall (CEO) |
Authorized Official Contact | 7608209229 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6530 La Contenta Rd Ste 100 Yucca Valley CA 92284-7313 Ph: (760) 820-9229 | 6380 Split Rock Ave Ste 29 Palms CA 92277-2550 Ph: (760) 365-9305 |
NPI Number | 1053733527 |
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Provider Enumeration Date | 01/17/2014 |
Last Update Date | 01/09/2023 |
Medicare PECOS PAC ID | 1254240898 |
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Medicare Enrollment ID | O20140813002727 |
Identifier | Type | State | Issuer |
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1053733527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |