Primehealth 360 Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRIMEHEALTH 360 INC

Practice address

79440 Corporate Center Dr Ste 111a
La Quinta, CA 92253-7243

Phone

(760) 444-1422

NPI assigned

Nov 13, 2019

Organization subpart

No

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

Authorized official

Name

Nina K Maw Maw, MDNPI 1407851777

Title

Owner

Phone

(760) 444-1422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

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

• Nina Khin Maw Maw, M.D.

  • Family Medicine Physician
  • Rancho Mirage, CA
  • NPI 1407851777
  Medicare reassignment NPD Authorized official
• Flordeliza Santos Mendoza, ACNPC-AG, FNP-C

  • Acute Care Nurse Practitioner
  • Rancho Mirage, CA
  • NPI 1326505108
  NPD
• Meagan Leah Beavers, NP

  • Family Nurse Practitioner
  • Coachella, CA
  • NPI 1093467664
  NPD (past)
• Joanne S Delgado, NP

  • Family Medicine Physician
  • Indio, CA
  • NPI 1821683806
  NPD (past)
• Shailaja Karanti, PHARM D

  • Pharmacist
  • Rancho Mirage, CA
  • NPI 1811343304
  NPD (past)

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1184269177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79440 CORPORATE CENTER DR STE 111A",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537243",
            "telephone_number": "760-444-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79440 CORPORATE CENTER DR STE 111A",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537243",
            "telephone_number": "760-444-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMEHEALTH 360 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "MAW MAW",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-444-1422",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy Macbeth Pitkin, M.D.
• Morris D Platt, MD
• Daniela M Preciado
• Angela K Prescott, P.T.
• Primary Care Sports MD Group Inc
• Priority Home Health Services, LLC
• Prospero Wellness Center Inc
• Jay Jacob Protass, M.D.
• PT Works Inc (Concierge Therapy Works)
• Natasha Putter

• Family Medicine Physician in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.