Provider Demographics
NPI:1639696412
Name:ARCHIS DESAI MD INC.
Entity Type:Organization
Organization Name:ARCHIS DESAI MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARCHIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-966-5500
Mailing Address - Street 1:1030 NEVADA ST STE 101
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2957
Mailing Address - Country:US
Mailing Address - Phone:909-966-5500
Mailing Address - Fax:909-966-5222
Practice Address - Street 1:1030 NEVADA ST STE 101
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2957
Practice Address - Country:US
Practice Address - Phone:909-966-5500
Practice Address - Fax:909-966-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty