Provider Demographics
NPI:1346597440
Name:DESERT CARE FAMILY CLINIC PLLC
Entity Type:Organization
Organization Name:DESERT CARE FAMILY CLINIC PLLC
Other - Org Name:DESERT CARE FAMILY & SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-371-9781
Mailing Address - Street 1:1968 N PEART RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-2495
Mailing Address - Country:US
Mailing Address - Phone:520-518-5889
Mailing Address - Fax:
Practice Address - Street 1:1968 N PEART RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-2495
Practice Address - Country:US
Practice Address - Phone:520-518-5889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42143261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care