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Organization

DESERT NEUROLOGY MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IVOR J NAZARETH M.D. (OWNER)
(760) 568-3563
Entity
Organization

Contact information

Practice address
39000 BOB HOPE DRIVE, PROBST BLDG 311, RANCHO MIRAGE, CA 92270
(760) 568-3563
(760) 346-9887
Mailing address
39000 BOB HOPE DRIVE, PROBST BLDG 311, RANCHO MIRAGE, CA 92270
(760) 568-3563
(760) 346-9887

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A30151
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A301510
CA
Enumeration date
02/24/2006
Last updated
09/08/2008
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