HI -DESERT MEMORIAL HEALTH CARE DISTRICT (NPI# 1649708611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649708611 |
| Entity Type | Organization |
| Organization Name | HI -DESERT MEMORIAL HEALTH CARE DISTRICT |
| Other Organization Name | MORONGO BASIN COMMUNITY HEALTH CENTER-BH |
| Practice Address |
58383 29 Palms Hwy Ste 101 Yucca Valley CA 92284-5891 |
| Practice Telephone | 7603659305 |
| Practice Fax Number | 7603659309 |
| Mailing Telephone | 7603659305 |
| Mailing Fax Number | 7603659309 |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2019-07-19 |
| 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) |
CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Morongo Basin Community Health Center | Doing Business As Name - Organization |
| Morongo Basin Community Health Center-BH | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 57463 Twentynine Palms Hwy., Suite 202, Yucca Valley, CA 92284 | 7603659305 | 7603661544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912475088 | Hi -desert Memorial Health Care District | Clinic/Center | 6370 Split Rock Ave, 29 Palms, CA 92277-2550 | 2018-11-07 |
| 1467920538 | Hi -desert Memorial Health Care District | Clinic/Center | 6540 La Contenta Rd Ste 400, Yucca Valley, CA 92284-7320 | 2018-11-07 |
| 1003369620 | Hi -desert Memorial Health Care District | Clinic/Center | 57019 Yucca Trail Ste C, Yucca Valley, CA 92284 | 2016-08-01 |
| 1730710443 | Hi -desert Memorial Health Care District | Private Vehicle | 6530 La Contenta Rd Ste 100, Yucca Valley, CA 92284-7313 | 2020-01-31 |
| 1518475987 | Hi -desert Memorial Health Care District | Clinic/Center | 6380 Split Rock Ave, 29 Palms, CA 92277-2550 | 2018-01-18 |
| Street Address |
58383 29 PALMS HWY STE 101 |
| City | YUCCA VALLEY |
| State | CA |
| Zip Code | 92284-5891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780772574 | Austin Vincent Puglisi | Psychiatry & Neurology | 58383 29 Palms Hwy Ste 101, Yucca Valley, CA 92284-5891 | 2006-10-10 |
| 1437619624 | Lauren Cobb | Nurse Practitioner | 58383 29 Palms Hwy Ste 101, Yucca Valley, CA 92284-5891 | 2019-03-22 |
| 1508217399 | Priscilla Campos | Family Medicine | 58383 29 Palms Hwy Ste 101, Yucca Valley, CA 92284-5891 | 2016-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821646746 | Dawn Irene Blue | Registered Nurse | 55887 Yucca Valley Trail, Yucca Valley, CA 92284 | 2019-09-04 |
| 1659838415 | Lifeline Marketing Group, LLC Kenneth M Folwell Sole Mbr | Genetic Counselor, MS | 57675 Twentynine Palms Hwy, Suite 102, Yucca Valley, CA 92284 | 2019-02-27 |
| 1790240026 | Rosenda Marie Quintero | Case Manager/Care Coordinator | 7281 Dumosa Avneue, Ste 4, Yucca Valley, CA 92284 | 2019-01-31 |
| 1740790617 | Robert Farrer | Pharmacist | 57701 Twentynine Palms Highway, Yucca Valley, CA 92284 | 2017-10-05 |
| 1881128981 | Louis James Medina | Case Manager/Care Coordinator | 58471 Twentynine Palms Hwy #102, Yucca Valley, CA 92284 | 2017-04-14 |
| 1003369620 | Hi -desert Memorial Health Care District | Clinic/Center | 57019 Yucca Trail Ste C, Yucca Valley, CA 92284 | 2016-08-01 |
| 1346639002 | Virginia Susan Mccann | Marriage & Family Therapist | 58945 Business Cernter Drive, Suite D, Yucca Valley, CA 92284 | 2015-01-20 |
| 1578964375 | Desert Oasis Healthcare | Clinic/Center | 57-840 29 Palms Hwy, Yucca Valley, CA 92284 | 2014-09-11 |
| 1306245113 | Katie Z Topper | Nurse Practitioner | 57402 Twentynine Palm Highway, Ste 1, Yucca Valley, CA 92284 | 2014-08-18 |
| 1215347307 | Sandip Patel | Pharmacist | 57701 Twentynine Palms Hwy, Yucca Valley, CA 92284 | 2014-04-29 |
| Find all providers in zip 92284 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003369620 | Hi -desert Memorial Health Care District | Clinic/Center | 57019 Yucca Trail Ste C, Yucca Valley, CA 92284 | 2016-08-01 |
| 1841612082 | Hi-desert Memorial Health Care District | Clinic/Center | 58375 29 Palms Hwy, Yucca Valley, CA 92284-5890 | 2014-01-07 |
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| Find all providers with the same taxonomy | ||||
| City | YUCCA VALLEY |
| Zip Code | 92284 |
Please comment or provide details below to improve the information on HI -DESERT MEMORIAL HEALTH CARE DISTRICT.
| 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.