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Organization
MORONGO MEDICAL GROUP INC
Active
Organization
MORONGO MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PREM P SALHOTRA MD (PRESIDENT)
(760) 228-1929
Entity
Organization
Contact information
Practice address
57725 29 PALMS HWY, STE 401, YUCCA VALLEY, CA 92284-3044
(760) 228-1929
(760) 228-9633
Mailing address
PO BOX 1809, YUCCA VALLEY, CA 92286-1809
(760) 228-1929
(760) 228-9633
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A426710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7451
RAILROAD GROUP NO
CA
05
—
GR0078500
—
CA
01
—
ZZ53804AZ
BLUE SHIELD OF CA
CA
Enumeration date
02/08/2007
Last updated
01/29/2021
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