Provider Demographics
NPI:1568185700
Name:MYDOCTORS, INC., A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MYDOCTORS, INC., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSENZE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:612-205-5793
Mailing Address - Street 1:1222 PALMAS RDG
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-1259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:236-471-1730
Practice Address - Street 1:555 E TACHEVAH DR STE 3W105
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5747
Practice Address - Country:US
Practice Address - Phone:916-936-2722
Practice Address - Fax:236-471-1730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center