Provider Demographics
NPI:1346937133
Name:RANCHO MIRAGE PEDIATRICS, INC.
Entity Type:Organization
Organization Name:RANCHO MIRAGE PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER (CEO)
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTANILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-770-0000
Mailing Address - Street 1:35900 BOB HOPE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1767
Mailing Address - Country:US
Mailing Address - Phone:760-770-0000
Mailing Address - Fax:760-770-2727
Practice Address - Street 1:35900 BOB HOPE DR STE 140
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1767
Practice Address - Country:US
Practice Address - Phone:760-770-0000
Practice Address - Fax:760-770-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty