| Organization Name: | CONCEPT MEDICAL ASSOCIATES |
| NPI Number: | 1013151364 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAJU KHANCHUSTAMBHAM (DIRECTOR) |
| Mailing Address: | 35400 Bob Hope Dr Suite # 209 Rancho Mirage |
| State: | CA US |
| Postal Code: | 922701772 |
| Phone Number: | 7606997117 |
| Fax Number: | 7606997750 |
| NPI Enumeration Date: | 04/29/2009 |
| NPI Last Update Date: | 05/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | A86478 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |