Individual
MRS. GISI STUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
77135 INDIANA AVE, PALM DESERT, CA 92211-7715
(760) 772-7996
Mailing address
77135 INDIANA AVE, PALM DESERT, CA 92211-7715
(760) 772-7996
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1689
CA
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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