Organization Active NPI

My Optimal Life

  • Psychiatry Physician
  • Rancho Mirage, CA
National Provider Identifier
1013526862
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MY OPTIMAL LIFE
Practice address
72301 Country Club Dr Ste 105
Rancho Mirage, CA 92270-8007
Phone
(760) 691-2069
NPI assigned
Jul 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Brossfield
Title
Clinic Manager
Phone
(760) 691-2069

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

72301 Country Club Dr Ste 105
Rancho Mirage, CA 92270-8007

Mailing address

72301 Country Club Dr Ste 105
Rancho Mirage, CA 92270-8007
Phone (706) 567-8207

Other practice location 1

312 Brookside Ave
Redlands, CA 92373-4608
Phone (951) 271-0397

National Provider Directory

National Provider Directory

Locations

72301 Country Club Dr
Ste 105
Rancho Mirage, CA 92270
Phone (760) 541-6163

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1013526862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72301 COUNTRY CLUB DR STE 105",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922708007",
            "telephone_number": "706-567-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72301 COUNTRY CLUB DR STE 105",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922708007",
            "telephone_number": "760-691-2069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 Brookside Ave",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923734608",
            "country_code": "US",
            "telephone_number": "951-271-0397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY OPTIMAL LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "BROSSFIELD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "760-691-2069"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.