Provider Demographics
NPI:1467584425
Name:DESERT VIP URGENT CARE MED ASS
Entity Type:Organization
Organization Name:DESERT VIP URGENT CARE MED ASS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TING
Authorized Official - Middle Name:Z
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-674-1923
Mailing Address - Street 1:72630 FRED WARING DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5004
Mailing Address - Country:US
Mailing Address - Phone:760-674-1923
Mailing Address - Fax:
Practice Address - Street 1:72630 FRED WARING DR STE 101
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5004
Practice Address - Country:US
Practice Address - Phone:760-674-1923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04006ZOtherBS GROUP #
CAZZZ04006ZOtherBS GROUP #
CAZZZ23310ZMedicare ID - Type UnspecifiedMEDICARE GROUP #