Organization
DESERT DERMAESTHETICS, INC.
Active
Organization
DESERT DERMAESTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUTH ELLEN VANDERPLAS MD (PRESIDENT)
(760) 777-7993
Entity
Organization
Contact information
Practice address
47647 CALEO BAY DRIVE, SUITE 250, LA QUINTA, CA 92253-9998
(760) 777-7993
(760) 777-4244
Mailing address
47647 CALEO BAY DRIVE, SUITE 250, LA QUINTA, CA 92253-9998
(760) 777-7993
(760) 777-4244
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A88507
CA
208D00000X
General Practice Physician
A88507
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ60262Z
BLUE SHIELD PIN
CA
Enumeration date
04/10/2007
Last updated
08/19/2022
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