| Morongo Basin Community Health Center | |
|
58375 29 Palms Hwy Yucca Valley CA 92284-5890 | |
| (760) 365-9305 | |
| (866) 732-0113 |
| Full Name | Morongo Basin Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 58375 29 Palms Hwy, Yucca Valley, California |
| Authorized Official Name and Position | Cindy Schmall (C.E.O.) |
| Authorized Official Contact | 7608209229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Morongo Basin Community Health Center 6530 La Contenta Rd Ste 100 Yucca Valley CA 92284-7313 Ph: (760) 820-9229 | Morongo Basin Community Health Center 58375 29 Palms Hwy Yucca Valley CA 92284-5890 Ph: (760) 365-9305 |
| NPI Number | 1841612082 |
|---|---|
| Provider Enumeration Date | 01/07/2014 |
| Last Update Date | 08/15/2024 |
| Medicare PECOS PAC ID | 1254240898 |
|---|---|
| Medicare Enrollment ID | O20041201001069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841612082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | David M Mccollum |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1336206325 PECOS PAC ID: 6709856446 Enrollment ID: I20040729000431 |
| Provider Name | Daniel Joseph Fraschetti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275538241 PECOS PAC ID: 5092784348 Enrollment ID: I20041001001120 |
| Provider Name | Rajagopal K Sunder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972572824 PECOS PAC ID: 0941228605 Enrollment ID: I20120427000128 |
| Provider Name | Ann M Ala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083948012 PECOS PAC ID: 8426318767 Enrollment ID: I20180207000926 |
| Provider Name | Tina M Huff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073778767 PECOS PAC ID: 6305179912 Enrollment ID: I20190613003102 |
| Provider Name | Michael Racadio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649690298 PECOS PAC ID: 8921334129 Enrollment ID: I20190725002282 |
| Provider Name | Kimberly A Benton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275030066 PECOS PAC ID: 9537590658 Enrollment ID: I20200505002163 |
| Provider Name | Jasdeep Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285270611 PECOS PAC ID: 1254744535 Enrollment ID: I20210323001588 |
| Provider Name | Jack Stuart Cruikshank |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720746662 PECOS PAC ID: 5496141616 Enrollment ID: I20220414002211 |
| Provider Name | Katherine Naomi Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457984239 PECOS PAC ID: 3577940865 Enrollment ID: I20220505002129 |
| Provider Name | Tiffany Sidra Taylor-mduba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508500760 PECOS PAC ID: 3274902796 Enrollment ID: I20221206000067 |
| Provider Name | Brianna T Subero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932646619 PECOS PAC ID: 5294181699 Enrollment ID: I20231020001834 |
Morongo Basin Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 57019 Yucca Trail Ste C, Yucca Valley, CA 92284 Phone: 760-365-9305 | |
Edith A. Jones-poland Md And Assoc. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 56925 Yucca Trl, Number 232, Yucca Valley, CA 92284 Phone: 760-401-2502 | |
Omni Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7281 Dumosa Ave Ste 2, Yucca Valley, CA 92284 Phone: 760-365-2722 Fax: 760-365-5099 | |
Nowysz Regenerative Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55887 Yucca Trl, Yucca Valley, CA 92284 Phone: 760-365-0804 | |
Erwin C Demiany Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 57463 29 Palms Hwy, Yucca Valley, CA 92284 Phone: 760-228-1856 Fax: 760-228-1897 | |
Yucca Valley Family Medical Associates, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 57463 29 Palms Hwy, Suite 203, Yucca Valley, CA 92284 Phone: 760-228-1855 Fax: 760-228-1897 | |
All As Well Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 57725 29 Palms Hwy #401, Yucca Valley, CA 92284 Phone: 310-756-9363 |