Basic Information
| Provider Information | |||||||||
| NPI: | 1265423750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | HERBERT | ||||||||
| MiddleName: | STEPHEN | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 275 N EL CIELO RD | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922626972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603208814 | ||||||||
| FaxNumber: | 7603202725 | ||||||||
| Practice Location | |||||||||
| Address1: | 41120 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | BERMUDA DUNES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922039215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603603193 | ||||||||
| FaxNumber: | 7603202725 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 11/26/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA12978 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.