Provider Demographics
NPI:1295902492
Name:BRIGGS, DUSTIN T (MD)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:T
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
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:760-837-2290
Practice Address - Street 1:151 S SUNRISE WAY STE 100
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:760-837-2290
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA124871207XS0114X
NMMD2014-0617207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA124871OtherSTATE LICENSE