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DESERT PODIATRY GROUP NPI 1336168517


NPI Information

NPI: 1336168517
Provider Name: DESERT PODIATRY GROUP
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
69730 HIGHWAY 111
SUITE 101
RANCHO MIRAGE, CA
ZIP 92270
Phone: (760) 328-4669
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DESERT PODIATRY GROUP is a foot and ankle surgery podiatrist in Rancho Mirage, CA. DESERT PODIATRY GROUP NPI is 1336168517. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

69730 HIGHWAY 111
SUITE 101
RANCHO MIRAGE, CA
ZIP 92270-869
Phone: (760) 328-4669
Fax: (760) 328-6719

The provider's authorized official is Sheldon Collis .
The authorized official title is Partner and has the following contact phone number (760) 328-4669.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 11/21/2008.


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
1213ES0103XPodiatristFoot & Ankle SurgeryE21580CALIFORNIANo
2213ES0103XPodiatristFoot & Ankle SurgeryE38020CALIFORNIAYes

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
1000E21852MEDICAIDCALIFORNIA
2T11217MEDICARE UPINCALIFORNIA
3U25602MEDICARE UPINCALIFORNIA
4ZZZ18969ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
5000E38020MEDICAIDCALIFORNIA
64934630001MEDICARE NSCCALIFORNIA

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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