Provider Demographics
NPI:1255877940
Name:ADVANCED PRIMARY CARE OF HIGH DESERT, INC.
Entity type:Organization
Organization Name:ADVANCED PRIMARY CARE OF HIGH DESERT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:760-810-0888
Mailing Address - Street 1:16003 TUSCOLA RD STE H
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-0825
Mailing Address - Country:US
Mailing Address - Phone:760-810-0888
Mailing Address - Fax:760-316-2800
Practice Address - Street 1:16003 TUSCOLA RD STE H
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-0825
Practice Address - Country:US
Practice Address - Phone:760-810-0888
Practice Address - Fax:760-316-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11335174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty