| David Desai MD Inc | |
|
1030 Nevada St Ste 101 Redlands CA 92374-2957 | |
| (909) 966-5500 | |
| (909) 966-5222 |
| Full Name | David Desai MD Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1030 Nevada St Ste 101, Redlands, California |
| Authorized Official Name and Position | David Desai (OWNER) |
| Authorized Official Contact | 9515303294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Desai MD Inc 1030 Nevada St Ste 101 Redlands CA 92374-2957 Ph: (909) 966-5500 | David Desai MD Inc 1030 Nevada St Ste 101 Redlands CA 92374-2957 Ph: (909) 966-5500 |
| NPI Number | 1174901128 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 01/03/2022 |
| Certification Date | 01/03/2022 |
| Medicare PECOS PAC ID | 6204148794 |
|---|---|
| Medicare Enrollment ID | O20150713001240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174901128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A1004997 (California) | Primary |
| Provider Name | Ralph P Lissaur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245287960 PECOS PAC ID: 1557318870 Enrollment ID: I20050407000879 |
| Provider Name | David P Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740451566 PECOS PAC ID: 2961696885 Enrollment ID: I20101104000167 |
| Provider Name | Soumyadipta Hazra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124291224 PECOS PAC ID: 1355487364 Enrollment ID: I20200424002250 |
| Provider Name | Elma M Slough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982220588 PECOS PAC ID: 9234558289 Enrollment ID: I20200924002844 |
| Provider Name | Aizzel R Trieu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689214074 PECOS PAC ID: 9133539224 Enrollment ID: I20201030001028 |
| Provider Name | Akta Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437813706 PECOS PAC ID: 9739579368 Enrollment ID: I20211214000535 |
| Provider Name | Chika U Oguagha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316546930 PECOS PAC ID: 5193111318 Enrollment ID: I20220414001950 |
| Provider Name | Robert K Hull |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033545298 PECOS PAC ID: 8921464462 Enrollment ID: I20230525001240 |
| Provider Name | Jay Chae |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275237422 PECOS PAC ID: 8022475383 Enrollment ID: I20230601002444 |
| Provider Name | Roshana a Nazari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104647205 PECOS PAC ID: 8426585753 Enrollment ID: I20241226001675 |
| Provider Name | Shiny Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700638293 PECOS PAC ID: 2567989742 Enrollment ID: I20250512000435 |
| Provider Name | Grace T Somoso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124857602 PECOS PAC ID: 5193235463 Enrollment ID: I20250606001758 |
| Provider Name | Jayanta Pal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992899041 PECOS PAC ID: 3971562125 Enrollment ID: I20250721002436 |
| Provider Name | Harnek Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972198703 PECOS PAC ID: 9638655053 Enrollment ID: I20260115000647 |
| Provider Name | Komalben Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497619779 PECOS PAC ID: 9032697206 Enrollment ID: I20260129001658 |
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