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Organization
KONDOVSKI MEDICAL GROUP
Active
Organization
KONDOVSKI MEDICAL GROUP
Active
Other names
Kondovski Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SACHO RADE KONDOVSKI D.O. (OWNER)
(760) 565-6969
Entity
Organization
Contact information
Practice address
79440 CORPORATE CENTER DR. STE 110, LA QUINTA, CA 92253-7241
(760) 565-6969
(760) 565-6966
Mailing address
79440 CORPORATE CENTER DR. STE 110, LA QUINTA, CA 92253-7241
(760) 565-6969
(760) 565-6966
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020A60770
MEDICARE ID - TYPE UNSPECIFIED
CA
01
—
20A6077
MEDICAL LICENSE
CA
Enumeration date
09/30/2010
Last updated
03/07/2023
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