Active NPI
George Leonard Nelson, MD
- Adult Medicine Physician
- Indian Wells, CA
National Provider Identifier
1164905782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- C31229
- Practice address
- 75582 Camino de Plata N
Indian Wells, CA 92210-8519 - Phone
- (760) 674-7001
- NPI assigned
- Sep 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | C31229 | CA | Primary |
Addresses
Primary practice location
75582 Camino de Plata N
Indian Wells, CA 92210-8519
Mailing address
PO Box 4401
Palm Desert, CA 92261-4401
Phone (760) 674-7001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C31229 | CA | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536537600000",
"number": "1164905782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4401",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922614401",
"telephone_number": "760-674-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75582 CAMINO DE PLATA N",
"city": "INDIAN WELLS",
"state": "CA",
"postal_code": "922108519",
"telephone_number": "760-674-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "GEORGE",
"middle_name": "LEONARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-10",
"last_updated": "2018-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "CA",
"license": "C31229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indian Wells, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.