Provider Demographics
NPI:1073027603
Name:OASIS ADVANCED GASTROENTEROLOGY, INC.
Entity Type:Organization
Organization Name:OASIS ADVANCED GASTROENTEROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ASGERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-454-2770
Mailing Address - Street 1:44489 TOWN CENTER WAY STE D520
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2723
Mailing Address - Country:US
Mailing Address - Phone:440-454-2770
Mailing Address - Fax:
Practice Address - Street 1:100 N PALM CANYON DR STE 214
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5504
Practice Address - Country:US
Practice Address - Phone:760-699-7607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-17
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC128282207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty