Provider Demographics
NPI:1649482746
Name:WESTERN PRIMARY CARE INC
Entity type:Organization
Organization Name:WESTERN PRIMARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WESTERN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:760-320-1199
Mailing Address - Street 1:555 E TACHEVAH DR
Mailing Address - Street 2:STE 3W-101
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5750
Mailing Address - Country:US
Mailing Address - Phone:760-320-1199
Mailing Address - Fax:760-323-2769
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:STE 3W-101
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5750
Practice Address - Country:US
Practice Address - Phone:760-320-1199
Practice Address - Fax:760-323-2769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA7125208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty