Provider Demographics
NPI:1851828222
Name:DESERT VALLEY OBGYN INC
Entity Type:Organization
Organization Name:DESERT VALLEY OBGYN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ILBEIGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-515-6260
Mailing Address - Street 1:18400 US HIGHWAY 18 STE A
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2306
Mailing Address - Country:US
Mailing Address - Phone:760-242-3939
Mailing Address - Fax:760-242-3232
Practice Address - Street 1:39000 BOB HOPE DR STE 303
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-346-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207VG0400X
208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty