Desert Clinic, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A80383 Issued in CA

Legal business name

DESERT CLINIC, LLC

Practice address

36101 Bob Hope Dr
Ste B-2
Rancho Mirage, CA 92270-2001

Phone

(760) 321-1315

Fax

(760) 321-1094

NPI assigned

Apr 20, 2015

Last updated

Apr 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Heather McDonald

Title

Admin Manager

Phone

(949) 783-3600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1063809812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3857 BIRCH ST",
            "address_2": "#605",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602616",
            "telephone_number": "949-783-3600",
            "fax_number": "949-783-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36101 BOB HOPE DR",
            "address_2": "STE B-2",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702001",
            "telephone_number": "760-321-1315",
            "fax_number": "760-321-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "ADMIN MANAGER",
        "authorized_official_telephone_number": "949-783-3600"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A80383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor John Derderian, M.D.
• John George Desantis, D.O.
• Desert Breast & Osteoporosis Institute
• Desert Cardiology Consultants Medical Group
• Desert Cities Allergy Otolaryngology Inc
• Desert Colon & Rectal Medical Group,Inc.
• Desert Comprehensive Urology
• Desert Counseling & Assessment Center, a Psychological Corporation
• Desert Dermatology Medical Assoiates Inc
• Desert Ear, Nose & Throat Medical Group, Inc.

• Interventional Pain Medicine Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.