Provider Demographics
NPI:1598087223
Name:DESERT ORTHOPAEDIC CENTER, LTD.
Entity Type:Organization
Organization Name:DESERT ORTHOPAEDIC CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:PENDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-697-7236
Mailing Address - Street 1:2930 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE #100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5058
Mailing Address - Country:US
Mailing Address - Phone:702-263-9082
Mailing Address - Fax:702-263-9088
Practice Address - Street 1:2800 E DESERT INN RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3609
Practice Address - Country:US
Practice Address - Phone:702-731-1616
Practice Address - Fax:702-263-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty