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73345 Highway 111 Palm Desert CA 92260-3909 | |
(760) 340-5800 | |
(760) 340-5700 |
Full Name | |
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Speciality | Internal Medicine |
Location | 73345 Highway 111, Palm Desert, California |
Authorized Official Name and Position | Manzoor A Kazi (CEO) |
Authorized Official Contact | 7603405800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1118 Palm Desert CA 92261-1118 Ph: (760) 340-5800 | 73345 Highway 111 Palm Desert CA 92260-3909 Ph: (760) 340-5800 |
NPI Number | 1003849621 |
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Provider Enumeration Date | 07/08/2006 |
Last Update Date | 06/25/2013 |
Medicare PECOS PAC ID | 0648244608 |
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Medicare Enrollment ID | O20040825000430 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003849621 | NPI | - | NPPES |
00A641060 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 00A641060 (California) | Primary |
Provider Name | Manzoor A Kazi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225032212 PECOS PAC ID: 4486645777 Enrollment ID: I20040524001424 |
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 | |
Jitka Civrna Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74000 Country Club Dr Ste G2, Palm Desert, CA 92260 Phone: 760-773-4948 Fax: 760-773-4910 | |