Desert Dermatology Medical Assoiates Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

G057257 Issued in CA

Legal business name

DESERT DERMATOLOGY MEDICAL ASSOIATES INC

Practice address

72301 Country Club Dr
Suite101
Rancho Mirage, CA 92270-8007

Phone

(760) 346-4262

Fax

(760) 340-9892

NPI assigned

Mar 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Wendy Eileen Roberts, MDNPI 1689663635

Title

Owner/President

Phone

(760) 346-4262

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Wendy Eileen Roberts, M.D.

  • Dermatology Physician
  • Rancho Mirage, CA
  • NPI 1689663635
  NPD (past) Authorized official

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1023289840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72301 COUNTRY CLUB DR",
            "address_2": "SUITE101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922708007",
            "telephone_number": "760-346-4262",
            "fax_number": "760-340-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72301 COUNTRY CLUB DR",
            "address_2": "SUITE101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922708007",
            "telephone_number": "760-346-4262",
            "fax_number": "760-340-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT DERMATOLOGY MEDICAL ASSOIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "760-346-4262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G057257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "ZZZ03127Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.