Organization
UCR PALM SPRINGS - EL MIRADOR PRACTICE
Active
Parent organization
UNIVERSITY OF CALIFORNIA REGENTS
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF CALIFORNIA REGENTS
Authorized official
JOHN A. HEYDT MD (SR. ASSOC. DEAN, CLINICAL AFFAIRS)
(714) 456-2986
Entity
Organization
Contact information
Practice address
1180 N INDIAN CANYON DR, SUITE E425, PALM SPRINGS, CA 92262-4800
(760) 537-1632
Mailing address
PO BOX 54779, LOS ANGELES, CA 90054-0779
(866) 819-6298
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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