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FAMILY HEALTH CENTER OF JOSHUA TREE NPI 1639405004


NPI Information

NPI: 1639405004
Provider Name: FAMILY HEALTH CENTER OF JOSHUA TREE

Doing Business As: HIGH DESERT FAMILY MEDICAL CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D1036773

Address:
7350 CHURCH ST
YUCCA VALLEY, CA
ZIP 92284
Phone: (760) 369-3069
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FAMILY HEALTH CENTER OF JOSHUA TREE is a family medicine in Yucca Valley, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAMILY HEALTH CENTER OF JOSHUA TREE NPI is 1639405004. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As High Desert Family Medical Clinic.

The provider's business location address is:

7350 CHURCH ST
YUCCA VALLEY, CA
ZIP 92284-246
Phone: (760) 369-3069
Fax: (760) 369-3072

The provider's authorized official is Andre M Kasko .
The authorized official title is President and has the following contact phone number (760) 369-3069.

The CLIA number assigned to this NPI record is 05D1036773 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/20/2009 and was last updated on 10/20/2009.


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
1207Q00000XFamily Medicine20A6300CALIFORNIAYes

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
1553845OTHERCALIFORNIAMEDICARE IDENTIFICATION NUMBER

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: 4/28/2024

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