Basic Information
| Provider Information | |||||||||
| NPI: | 1497139190 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MD-CALIFORNIA INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2953 CANDLELIGHT LN | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922646823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064377633 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1150 N INDIAN CANYON DR | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922624872 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603236605 | ||||||||
| FaxNumber: | 7603236528 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2015 | ||||||||
| LastUpdateDate: | 07/13/2015 | ||||||||
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| AuthorizedOfficialLastName: | WEINSTEIN | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2064377633 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | G88894 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.