Mattie Evans Alderman Foundation, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A27983 Issued in CA

Legal business name

MATTIE EVANS ALDERMAN FOUNDATION, INC.

Practice address

41800 Washington St
Suite #110
Bermuda Dunes, CA 92203-8150

Phone

(760) 345-2696

Fax

(760) 345-4961

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert Leroy Harmon, M.D.

Title

Medical Director

Phone

(760) 345-2696

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1356452437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41800 WASHINGTON ST",
            "address_2": "SUITE #110",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922038150",
            "telephone_number": "760-345-2696",
            "fax_number": "760-345-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 WASHINGTON ST",
            "address_2": "SUITE #110",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922038150",
            "telephone_number": "760-345-2696",
            "fax_number": "760-345-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTIE EVANS ALDERMAN FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "HARMON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "760-345-2696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A27983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexei Lyapustin, PT, DPT
• Joseph Bautista Manalo, PT
• Fred H Mann, RPH
• Susan Marder, ANP-C
• Mattie Evans Alderman Foundation for Preventive Medicine, Inc.
• James R Mawhiney, DPT
• Bridgid McQuown, EDD
• Medical Wellness Group, Inc.
• Kristin Metz, PTA
• Noelle Diane Millsap Harriman

• Clinic/Center in Bermuda Dunes, CA
• Providers in Bermuda Dunes, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.