Organization
BEZERK PRODUCTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC PAUL MILLER (PROJECT MANAGER)
(602) 312-1551
Entity
Organization
Contact information
Practice address
56300 TWENTYNINE PALMS HIGHWAY, 118, YUCCA VALLEY, CA 92284-7311
(760) 853-0186
Mailing address
PO BOX 1972, JOSHUA TREE, CA 92252-0859
(760) 853-0186
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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