NPIMap

Organization Active NPI

Etebar Medical Consultants, Inc.

  • Neurological Surgery Physician
  • Palm Desert, CA
National Provider Identifier
1346664695
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
G72753 Issued in CA
Legal business name
ETEBAR MEDICAL CONSULTANTS, INC.
Practice address
73710 Alessandro Dr
Palm Desert, CA 92260-3638
Phone
(760) 346-8058
Fax
(417) 890-9127
NPI assigned
Feb 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Authorized official

Name
Dr. Shahin Etebar, M.D.
Title
President
Phone
(760) 346-8058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X G72753 CA Primary

Addresses

Primary practice location

73710 Alessandro Dr
Palm Desert, CA 92260-3638

Mailing address

PO Box 1269
Rancho Mirage, CA 92270-1053
Phone (760) 346-8058

National Provider Directory

National Provider Directory

Locations

73710 Alessandro Dr
Palm Desert, CA 92260
Phone (760) 837-0364

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391644800000",
    "number": "1346664695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1269",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701053",
            "telephone_number": "760-346-8058",
            "fax_number": "417-890-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73710 ALESSANDRO DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603638",
            "telephone_number": "760-346-8058",
            "fax_number": "417-890-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETEBAR MEDICAL CONSULTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-06",
        "last_updated": "2014-02-06",
        "status": "A",
        "authorized_official_last_name": "ETEBAR",
        "authorized_official_first_name": "SHAHIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-346-8058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G72753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.