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DESERT NEUROLOGY MEDICAL GROUP NPI 1205802717


NPI Information

NPI: 1205802717
Provider Name: DESERT NEUROLOGY MEDICAL GROUP
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
39000 BOB HOPE DRIVE
PROBST BLDG 311
RANCHO MIRAGE, CA
ZIP 92270
Phone: (760) 568-3563
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DESERT NEUROLOGY MEDICAL GROUP is a neurology psychiatry neurology in Rancho Mirage, CA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DESERT NEUROLOGY MEDICAL GROUP NPI is 1205802717. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

39000 BOB HOPE DRIVE
PROBST BLDG 311
RANCHO MIRAGE, CA
ZIP 92270
Phone: (760) 568-3563
Fax: (760) 346-9887

The provider's authorized official is Ivor J Nazareth .
The authorized official title is Owner and has the following contact phone number (760) 568-3563.

The enumeration date for this NPI number is 2/24/2006 and was last updated on 9/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyA30151CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ80841ZMEDICARE ID-TYPE UNSPECIFIED
2A25987MEDICARE UPIN
300A301510MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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