Provider Demographics
NPI:1508051665
Name:SANTA ROSA DEL VALLE MEDICAL GROUP
Entity Type:Organization
Organization Name:SANTA ROSA DEL VALLE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-775-4181
Mailing Address - Street 1:81893 DR CARREON BLVD
Mailing Address - Street 2:SUITE #4
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5592
Mailing Address - Country:US
Mailing Address - Phone:760-775-4181
Mailing Address - Fax:760-775-4818
Practice Address - Street 1:1293 6TH ST
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1707
Practice Address - Country:US
Practice Address - Phone:760-391-5151
Practice Address - Fax:760-391-5159
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDIO EMERGENCY MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABCP53882FMedicaid