Organization
DESERT DERMATOLOGY MEDICAL ASSOIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDY EILEEN ROBERTS MD (OWNER/PRESIDENT)
(760) 346-4262
Entity
Organization
Contact information
Practice address
72301 COUNTRY CLUB DR, SUITE101, RANCHO MIRAGE, CA 92270-8007
(760) 346-4262
(760) 340-9892
Mailing address
72301 COUNTRY CLUB DR, SUITE101, RANCHO MIRAGE, CA 92270-8007
(760) 346-4262
(760) 340-9892
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G057257
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ03127Z
MEDICARE PROVIDER NUMBER
CA
Enumeration date
03/19/2008
Last updated
07/09/2008
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