# JACQUELINE SEVILLA MD A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114301298
- **Authorized official:** JACQUELINE SEVILLA MD (PRESIDENT)
- **Authorized official phone:** (760) 342-2295

## Contact information

- **Practice address:** 81715 DOCTOR CARREON BLVD, A-1, INDIO, CA 92201-0601
- **Practice address phone:** (760) 323-9309
- **Practice address fax:** (760) 610-8995
- **Mailing address:** 81715 DOCTOR CARREON BLVD, A-1, INDIO, CA 92201-0601
- **Mailing address phone:** (760) 323-9309
- **Mailing address fax:** (760) 610-8995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | A87837 | CA | Yes |

## Other

- **Enumeration date:** 07/17/2015
- **Last updated:** 07/17/2015