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73-211 Fred Waring Drive, Ste. 100 Palm Desert CA 92260 | |
(760) 568-4939 | |
(760) 341-8544 |
Full Name | |
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Speciality | Family Medicine |
Location | 73-211 Fred Waring Drive, Ste. 100, Palm Desert, California |
Authorized Official Name and Position | A. Gregory Caruso (PHYSICIAN) |
Authorized Official Contact | 7605684939 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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73211 Fred Waring Dr Suite 100 Palm Desert CA 92260-2871 Ph: (760) 568-4939 | 73-211 Fred Waring Drive, Ste. 100 Palm Desert CA 92260 Ph: (760) 568-4939 |
NPI Number | 1215149745 |
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Provider Enumeration Date | 05/04/2007 |
Last Update Date | 01/09/2012 |
Medicare PECOS PAC ID | 9739129198 |
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Medicare Enrollment ID | O20050505000529 |
Identifier | Type | State | Issuer |
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1215149745 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Alfred Caruso |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508825662 PECOS PAC ID: 9739240227 Enrollment ID: I20100126000294 |
Provider Name | John C Romano |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1134330558 PECOS PAC ID: 1658523733 Enrollment ID: I20121219000134 |
Provider Name | Victor Meier |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396008595 PECOS PAC ID: 3476851528 Enrollment ID: I20160406001060 |
Provider Name | Romina Mcgalliard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609493451 PECOS PAC ID: 8628424462 Enrollment ID: I20231030003475 |
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 | |