La Quinta Medspa, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G79952 Issued in CA

Legal business name

LA QUINTA MEDSPA, INC.

Practice address

47-350 Washington Street
Suite 103
La Quinta, CA 92253

Phone

(760) 396-9353

Fax

(760) 564-9577

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Matthew Loren Werner, M.D.

Title

Medical Director

Phone

(760) 396-9353

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Joshua Holcombe, PA

  • Medical Physician Assistant
  • Rancho Mirage, CA
  • NPI 1528501582
  NPD (past)

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1053506287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47350 WASHINGTON ST",
            "address_2": "SUITE 103",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922538847",
            "telephone_number": "760-396-9353",
            "fax_number": "760-564-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47-350 WASHINGTON STREET",
            "address_2": "SUITE 103",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "92253",
            "telephone_number": "760-396-9353",
            "fax_number": "760-564-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA QUINTA MEDSPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "LOREN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "760-396-9353",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G79952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Bohnet, DC, Lac, Acupuncture Corporation
• Debra J Kuracina, M.D.
• La Quinta Care
• La Quinta Ear Nose & Throat, Inc.
• La Quinta Kidney Center LLC
• La Quinta Pharmacy
• La Quinta Surgery Center a Medical Corporation
• Lagniappe Anesthesia
• Eugene Lam, MD
• Katherine Frances Lambert, N.P.

• Specialist in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; 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.