Basic Information
| Provider Information | |||||||||
| NPI: | 1003355348 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DESERT HOSPITALIST GROUP INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2783 SILVER OAK CT | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919142655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194714372 | ||||||||
| FaxNumber: | 8883078495 | ||||||||
| Practice Location | |||||||||
| Address1: | 1150 N INDIAN CANYON DR | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922624872 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194714372 | ||||||||
| FaxNumber: | 8883078495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2017 | ||||||||
| LastUpdateDate: | 02/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | MARTIN | ||||||||
| AuthorizedOfficialFirstName: | GERARDO | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6194714372 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A1335 | CA | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | 20A9554 | CA | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | A100776 | CA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.