Provider Demographics
NPI:1255490819
Name:DAP HEALTH, INC.
Entity Type:Organization
Organization Name:DAP HEALTH, INC.
Other - Org Name:DAP HEALTH-CENTRO MEDICO THERMAL-88175 AVENUE 76
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-323-2118
Mailing Address - Street 1:1695 N. SUNRISE WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-323-2118
Mailing Address - Fax:858-634-6901
Practice Address - Street 1:88775 AVENUE 76
Practice Address - Street 2:STE. 1
Practice Address - City:THERMAL
Practice Address - State:CA
Practice Address - Zip Code:92274
Practice Address - Country:US
Practice Address - Phone:760-397-2501
Practice Address - Fax:760-397-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA051097Medicare Oscar/Certification