Central Desert Medical Group

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

20A5179 Issued in CA

Legal business name

CENTRAL DESERT MEDICAL GROUP

Practice address

18031 US Highway 18
Suite a
Apple Valley, CA 92307-2152

Phone

(760) 242-7003

Fax

(760) 242-7703

NPI assigned

Jan 13, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Gwendolyn Grove

Title

Director of Operations

Phone

(760) 242-7003

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1831494343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18031 US HIGHWAY 18",
            "address_2": "SUITE A",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072152",
            "telephone_number": "760-242-7003",
            "fax_number": "760-242-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18031 US HIGHWAY 18",
            "address_2": "SUITE A",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072152",
            "telephone_number": "760-242-7003",
            "fax_number": "760-242-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DESERT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "GROVE",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "760-242-7003",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "20A5179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CCF&K Limited Liability Company (Community Care Pharmacy)
• Enrique Ceballos
• Rosallyn Celle, PPS-210032381
• Center for Surgical Excellence Inc
• Central Desert Industrial Medical Group a Professional Corporation
• Cep America - California (Vituity)
• Shanmuganathan Chandramohan, M.D.
• Lauren Channel
• Kierstin Mae Charlier
• Charter High Desert Health Care Group, LLC

• Preventive Medicine/Occupational Environmental Medicine Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.