Provider Demographics
NPI:1316402688
Name:WENDY E ROBERTS INC
Entity Type:Organization
Organization Name:WENDY E ROBERTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-346-4262
Mailing Address - Street 1:35280 BOB HOPE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1753
Mailing Address - Country:US
Mailing Address - Phone:760-346-4262
Mailing Address - Fax:760-340-9892
Practice Address - Street 1:35280 BOB HOPE DR STE 105
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1753
Practice Address - Country:US
Practice Address - Phone:760-346-4262
Practice Address - Fax:760-340-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty