Organization
LAS PALMAS OB GYN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE BAYNE (PRACTICE ADMINISTRATOR)
(760) 610-8985
Entity
Organization
Contact information
Practice address
72027 HIGHWAY 111, SUITE A, RANCHO MIRAGE, CA 92270-4961
(760) 610-8985
(760) 610-8998
Mailing address
72027 HIGHWAY 111, SUITE A, RANCHO MIRAGE, CA 92270-4961
(760) 610-8985
(760) 610-8998
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ89650Z
MEDICARE PTAN
CA
Enumeration date
01/22/2011
Last updated
01/22/2011
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