Mattie Evans Alderman Foundation for Preventive Medicine, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A279830 Issued in CA

Legal business name

MATTIE EVANS ALDERMAN FOUNDATION FOR PREVENTIVE MEDICINE, INC.

Practice address

41800 Washington St Ste 110
Bermuda Dunes, CA 92203-8150

Phone

(760) 345-2696

Fax

(760) 345-4961

NPI assigned

Feb 26, 2010

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

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1710209119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41800 WASHINGTON ST STE 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 STE 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 FOR PREVENTIVE MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-02-26",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A279830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Lestari, PHARMD
• Alexei Lyapustin, PT, DPT
• Joseph Bautista Manalo, PT
• Fred H Mann, RPH
• Susan Marder, ANP-C
• Mattie Evans Alderman Foundation, Inc.
• James R Mawhiney, DPT
• Bridgid McQuown, EDD
• Medical Wellness Group, Inc.
• Kristin Metz, PTA

• Family Medicine Physician in Bermuda Dunes, CA
• Providers in Bermuda Dunes, 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 Feb 26, 2010; 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.