Provider Demographics
NPI:1780220954
Name:DESERT ORTHOPEDIC CENTER A MEDICAL GROUP INC
Entity Type:Organization
Organization Name:DESERT ORTHOPEDIC CENTER A MEDICAL GROUP INC
Other - Org Name:DESERT ORTHOPEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-766-1246
Mailing Address - Street 1:PO BOX 1730
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1058
Mailing Address - Country:US
Mailing Address - Phone:760-568-2684
Mailing Address - Fax:760-341-5832
Practice Address - Street 1:151 S SUNRISE WAY STE 100 RM 2PS
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-0129
Practice Address - Country:US
Practice Address - Phone:760-568-2684
Practice Address - Fax:760-837-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies