Provider Demographics
NPI:1639407208
Name:DESERT OASIS HEALTHCARE
Entity Type:Organization
Organization Name:DESERT OASIS HEALTHCARE
Other - Org Name:LIVING AND AGING WELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:CPCS
Authorized Official - Phone:760-320-4122
Mailing Address - Street 1:340 S FARRELL DR STE A112
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7931
Mailing Address - Country:US
Mailing Address - Phone:760-969-6533
Mailing Address - Fax:760-969-5950
Practice Address - Street 1:340 S FARRELL DR STE A112
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7931
Practice Address - Country:US
Practice Address - Phone:760-969-6533
Practice Address - Fax:760-969-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty