Provider Demographics
NPI:1952536740
Name:JANET IHDE MD INC
Entity Type:Organization
Organization Name:JANET IHDE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:IHDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-416-4915
Mailing Address - Street 1:PO BOX 2131
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-2131
Mailing Address - Country:US
Mailing Address - Phone:760-416-4915
Mailing Address - Fax:760-416-4916
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE E150
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-4915
Practice Address - Fax:760-416-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38144174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty