Provider Demographics
NPI:1972777043
Name:TOTAL HEALTH OF THE DESERT A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:TOTAL HEALTH OF THE DESERT A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GHALEB
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAABBAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-323-4296
Mailing Address - Street 1:1100 N PALM CANYON DR STE 205
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4426
Mailing Address - Country:US
Mailing Address - Phone:760-323-4296
Mailing Address - Fax:760-320-9445
Practice Address - Street 1:1100 N PALM CANYON DR STE 205
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4426
Practice Address - Country:US
Practice Address - Phone:760-323-4296
Practice Address - Fax:760-320-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51805207R00000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF82637Medicare UPIN
CAZZZ07456ZMedicare PIN