# DESERT OPHTHALMOLOGY MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1699392506
- **Authorized official:** DR. WALLACE FRANKLIN GOLDBAN MD (PRACTICE OWNER)
- **Authorized official phone:** (760) 320-8497

## Contact information

- **Practice address:** 72650 FRED WARING DR STE 109, PALM DESERT, CA 92260-5008
- **Practice address phone:** (760) 776-8600
- **Mailing address:** 72650 FRED WARING DR STE 109, PALM DESERT, CA 92260-5008
- **Mailing address phone:** (760) 776-8600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/26/2020
- **Last updated:** 06/26/2020