Provider Demographics
NPI:1174634828
Name:DESERT HEART INSTITUTE, INC
Entity Type:Organization
Organization Name:DESERT HEART INSTITUTE, INC
Other - Org Name:DESERT HEART INSTITUTE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAIED
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIBIPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-416-1376
Mailing Address - Street 1:3973 VISTA VERDE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-1231
Mailing Address - Country:US
Mailing Address - Phone:760-416-1376
Mailing Address - Fax:760-416-1381
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE E318
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-1376
Practice Address - Fax:760-416-1381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80162174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A801620Medicaid
CA00A801620Medicaid
CAH28148Medicare UPIN
CAZZZ02736ZMedicare PIN