Organization
HALO MEDICAL GROUP
Active
Other names
DESERT MEDICAL IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
CORY HAMMOND (CFO)
(760) 776-8989
Entity
Organization
Contact information
Practice address
74785 US HIGHWAY 111, SUITE 101, INDIAN WELLS, CA 92210-7128
(760) 776-8989
(760) 501-0311
Mailing address
PO BOX 841163, LOS ANGELES, CA 90084-1163
(760) 776-8989
(760) 779-8073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
FNP25453
CA
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK9031
RAILROAD MEDICARE
CA
05
—
GR0083070
—
CA
05
—
GR0083071
—
CA
05
—
GR0083072
—
CA
05
—
GR0083073
—
CA
01
—
ZZZ02402Z
BLUE SHIELD PIN
CA
01
—
ZZZ05859Z
BLUE CROSS
CA
01
—
ZZZ57290Z
BLUE SHIELD PIN
CA
01
—
ZZZ64094Z
BLUE SHIELD PIN
CA
Enumeration date
01/23/2007
Last updated
04/22/2022
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