Provider Demographics
NPI:1083933840
Name:DESERT ORTHOPEDIC TRAUMA SERVICE
Entity Type:Organization
Organization Name:DESERT ORTHOPEDIC TRAUMA SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:DUFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-416-4511
Mailing Address - Street 1:PO BOX 1962
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-1962
Mailing Address - Country:US
Mailing Address - Phone:760-416-4511
Mailing Address - Fax:760-416-4512
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE W201
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-4511
Practice Address - Fax:760-416-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty