Provider Demographics
NPI:1851477582
Name:STAPLETON, ANN E (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4791 E PALM CANYON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-5232
Mailing Address - Country:US
Mailing Address - Phone:760-834-7930
Mailing Address - Fax:760-834-7931
Practice Address - Street 1:4791 E PALM CANYON DR STE 100
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-5232
Practice Address - Country:US
Practice Address - Phone:760-834-7930
Practice Address - Fax:760-834-7931
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57133207R00000X, 207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
8150OtherINTERNAL ID-MOTOR VEHICLE ID
WA000107649Medicare PIN
F18970Medicare UPIN
WA1851477582Medicaid
F18970Medicare UPIN