Organization
DESERT CARDIOLOGY CONSULTANTS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA DAVIS (BUSINESS OFFICE SUPERVISOR)
(760) 346-0642
Entity
Organization
Contact information
Practice address
39000 BOB HOPE DR, HAL B WALLIS BLDG, RANCHO MIRAGE, CA 92270-3221
(760) 346-0642
Mailing address
39000 BOB HOPE DR, HAL B WALLIS BLDG, RANCHO MIRAGE, CA 92270-3221
(760) 346-0642
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS6505
RAILROAD MEDICARE
CA
05
—
ZZZ71563Z
—
CA
Enumeration date
05/27/2006
Last updated
05/12/2008
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