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MIRAGE MEDICAL GROUP CENTER NPI 1356811061


NPI Information

NPI: 1356811061
Provider Name: MIRAGE MEDICAL GROUP CENTER
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
44650 VILLAGE CT STE 100
PALM DESERT, CA
ZIP 92260
Phone: (760) 346-4003
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MIRAGE MEDICAL GROUP CENTER is a general practice in Palm Desert, CA. MIRAGE MEDICAL GROUP CENTER NPI is 1356811061. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

44650 VILLAGE CT STE 100
PALM DESERT, CA
ZIP 92260-812
Phone: (760) 346-4003
Fax: (760) 346-4443

The provider's authorized official is Zoran Rubakovich .
The authorized official title is Administrator and has the following contact phone number (760) 346-4003.

The enumeration date for this NPI number is 11/26/2018 and was last updated on 11/26/2018.


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
1207N00000XDermatologyNo
2208D00000XGeneral PracticeYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.