Organization
FOOT AND ANKLE ASSOCIATES OF THE DESERT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E EBAUGH DPM (PRESIDENT)
(760) 863-0070
Entity
Organization
Contact information
Practice address
81709 DR CARREON BLVD, STE D3, INDIO, CA 92201-5509
(760) 863-0070
(760) 863-0048
Mailing address
81709 DR CARREON BLVD, STE D3, INDIO, CA 92201-5509
(760) 863-0070
(760) 863-0048
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4495
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E44950
—
CA
Enumeration date
05/17/2007
Last updated
08/07/2009
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