Will Family Medical Group, A Professional Corporation | |
42575 Washington St Palm Desert CA 92211-8850 | |
(760) 360-0333 | |
Not Available |
Full Name | Will Family Medical Group, A Professional Corporation |
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Speciality | Family Medicine |
Location | 42575 Washington St, Palm Desert, California |
Authorized Official Name and Position | Michael Lawrence Will (OWNER) |
Authorized Official Contact | 9894667094 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Will Family Medical Group, A Professional Corporation 42575 Washington St Palm Desert CA 92211-8850 Ph: (760) 360-0333 | Will Family Medical Group, A Professional Corporation 42575 Washington St Palm Desert CA 92211-8850 Ph: (760) 360-0333 |
NPI Number | 1356875157 |
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Provider Enumeration Date | 04/18/2017 |
Last Update Date | 04/12/2024 |
Medicare PECOS PAC ID | 5193095115 |
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Medicare Enrollment ID | O20170725002020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356875157 | NPI | - | NPPES |
A136246 | Other | CA | STATE LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A136246 (California) | Primary |
Provider Name | Lawrence A Mora |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205851615 PECOS PAC ID: 6305820846 Enrollment ID: I20040614001239 |
Provider Name | Michael Lawrence Will |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1073876090 PECOS PAC ID: 6507096617 Enrollment ID: I20150717000676 |
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