|
| |
|
552 S Paseo Dorotea Ste 5 Palm Springs CA 92264-1437 | |
| (760) 322-2520 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 552 S Paseo Dorotea Ste 5, Palm Springs, California |
| Authorized Official Name and Position | Corey King (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7603222520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
552 S Paseo Dorotea Ste 5 Palm Springs CA 92264-1437 Ph: (760) 322-2520 | 552 S Paseo Dorotea Ste 5 Palm Springs CA 92264-1437 Ph: (760) 322-2520 |
| NPI Number | 1518507599 |
|---|---|
| Provider Enumeration Date | 01/08/2020 |
| Last Update Date | 03/06/2020 |
| Medicare PECOS PAC ID | 2163851809 |
|---|---|
| Medicare Enrollment ID | O20200401002359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518507599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | William J Grimm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407841315 PECOS PAC ID: 5799771127 Enrollment ID: I20040421001897 |
| Provider Name | Patricia L Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730374943 PECOS PAC ID: 8426145475 Enrollment ID: I20131114001309 |
| Provider Name | Matilda Mangan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972035442 PECOS PAC ID: 4082745542 Enrollment ID: I20170525002357 |
Desert Hospitalist Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1150 N Indian Canyon Dr, Palm Springs, CA 92262 Phone: 619-471-4372 Fax: 888-307-8495 | |
Gastrointestinal Assoc A Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 E Tachevah Dr, Suite #1e-104, Palm Springs, CA 92262 Phone: 760-325-7601 Fax: 760-325-4281 | |
Cali Solutions, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 S Sunrise Way Ste A901, Palm Springs, CA 92262 Phone: 760-835-4041 Fax: 760-406-8515 | |
Oasis Advanced Gastroenterology, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 N Palm Canyon Dr Ste 214, Palm Springs, CA 92262 Phone: 760-699-7607 | |
Dave Patel, M.d., A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1180 N Indian Canyon Dr Ste E218, Palm Springs, CA 92262 Phone: 760-323-6830 | |
James W Shaner M D A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 173 S Civic Dr, Ste 4, Palm Springs, CA 92262 Phone: 760-864-6688 Fax: 760-864-6686 | |
Edmund Ayoub, Jr., M.d., Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3655 E Ramon Rd, Palm Springs, CA 92264 Phone: 760-835-4229 |