Provider Demographics
NPI:1710325683
Name:COACHELLA VALLEY CARE MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:COACHELLA VALLEY CARE MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-863-1592
Mailing Address - Street 1:81767 DR CARREON BLVD
Mailing Address - Street 2:201
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5597
Mailing Address - Country:US
Mailing Address - Phone:760-775-4181
Mailing Address - Fax:760-775-4818
Practice Address - Street 1:81767 DR CARREON BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5597
Practice Address - Country:US
Practice Address - Phone:760-391-5151
Practice Address - Fax:760-391-5159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty