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590 Palm Canyon Drive Suite 212 Borrego Springs CA 92004 | |
(760) 767-5112 | |
(760) 767-5613 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 590 Palm Canyon Drive, Borrego Springs, California |
Authorized Official Name and Position | Michael Douglas Dew (DIRECTOR OF MANAGED CARE OPERATIONS) |
Authorized Official Contact | 6193442815 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2369 Borrego Springs CA 92004-2369 Ph: (760) 767-5051 | 590 Palm Canyon Drive Suite 212 Borrego Springs CA 92004 Ph: (760) 767-5112 |
NPI Number | 1275809006 |
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Provider Enumeration Date | 03/27/2012 |
Last Update Date | 02/19/2013 |
Identifier | Type | State | Issuer |
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1275809006 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Borrego Stat Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 587 Palm Canyon Dr # 215, Borrego Springs, CA 92004 Phone: 760-837-0321 Fax: 760-837-9114 | |