Provider Demographics
NPI:1578162848
Name:DESERT TELEHEART INC
Entity Type:Organization
Organization Name:DESERT TELEHEART INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:IGTIBEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-240-0456
Mailing Address - Street 1:8635 W SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5858
Mailing Address - Country:US
Mailing Address - Phone:702-960-0333
Mailing Address - Fax:
Practice Address - Street 1:12384 MIDDLE CREEK ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89138
Practice Address - Country:US
Practice Address - Phone:702-960-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty