HI-DESERT MEMORIAL HEALTH CARE DISTRICT (NPI# 1053733527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053733527 |
Entity Type | Organization |
Organization Name | HI-DESERT MEMORIAL HEALTH CARE DISTRICT |
Other Organization Name | MORONGO BASIN COMMUNITY HEALTH CENTER |
Practice Address |
72724 29 Palms Hwy Ste 103 29 Palms CA 92277 |
Mailing Address |
58383 29 Palms Hwy Yucca Valley CA 92284-5890 |
Practice Telephone | 7603675906 |
Practice Fax Number | 7603675983 |
Mailing Telephone | 7608209229 |
Mailing Fax Number | 7608209228 |
Enumeration Date | 2014-01-17 |
Last Update Date | 2018-07-16 |
Authorized Official Name | JACQUELINE COMBS (CEO) |
Authorized Official Telephone | 7608209229 |
Is Organization Subpart | Y |
Parent Organization Name | HI -DESERT MEMORIAL HEALTH CARE DISTRICT |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Morongo Basin Community Health Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841612082 | Hi-desert Memorial Health Care District | Clinic/Center | 58375 29 Palms Hwy, Yucca Valley, CA 92284-5890 | 2014-01-07 |
Street Address |
72724 29 PALMS HWY STE 103 |
City | 29 PALMS |
State | CA |
Zip Code | 92277 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821699737 | William Bill Ngo | Dentist | 1591 Griffin Road Mcagcc, Twentynine Palms, CA 92277 | 2020-11-06 |
1932755352 | Candace Irene Myer | Registered Nurse | Mcagcc Mccs Stepping Stones, Del Zalle Dr Building 693, Twentynine Palms, CA 92277 | 2019-08-12 |
1831759018 | Courtney Vindigni | Student in an Organized Health Care Education/Training Program | Twentynine Palms, Fpo, AA 92277 | 2019-06-19 |
1841857612 | Jasmine E Gomez | Behavior Technician | 8315 Argos Rd, Unit A, 29 Palms, CA 92277 | 2019-05-28 |
1861961955 | Golam Subhani Chowdhury | Physician Assistant | 1st Marine Division 7th Marine Regiment, Twentynine Palms, CA 92277 | 2018-11-19 |
1093283202 | James Degracie | Dentist | 1519 Griffin Rd, Twentynine Palms, CA 92277 | 2018-11-06 |
1659829141 | Sang Eun Lee Dental Corp | Dentist | 72724 Twentynine Palms Hwy #102, Twentynine Palms, CA 92277 | 2016-09-14 |
1396115374 | Sarah Camille Paje | Dentist | 1591 Griffin Road, Twentynine Palms, CA 92277 | 2015-10-02 |
1871897389 | An Nguyen Dds Prof Corp | Dentist | 73666 Joshua Dr., Twentynine Palms, CA 92277 | 2010-12-28 |
1316181639 | Lois N Burton | Rehabilitation Practitioner | 73501 Hwy 62 Suite A, 29 Palms, CA 92277 | 2009-04-30 |
Find all providers in zip 92277 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.