Organization Name: | DESERT DERMATOLOGY MEDICAL ASSOIATES INC |
NPI Number: | 1023289840 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WENDY EILEEN ROBERTS (OWNER/PRESIDENT) |
Mailing Address: | 72301 Country Club Dr Suite101 Rancho Mirage |
State: | CA US |
Postal Code: | 922708007 |
Phone Number: | 7603464262 |
Fax Number: | 7603409892 |
NPI Enumeration Date: | 03/19/2008 |
NPI Last Update Date: | 07/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G057257 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |