| Desert Medical Imaging | |
|
74785 Us Highway 111 Suite 101 Indian Wells CA 92210-7128 | |
| (760) 776-8989 | |
| (760) 501-0311 |
| Full Name | Desert Medical Imaging |
|---|---|
| Speciality | Radiology |
| Location | 74785 Us Highway 111, Indian Wells, California |
| Authorized Official Name and Position | Cory Hammond (CFO) |
| Authorized Official Contact | 7607768989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Medical Imaging Po Box 841163 Los Angeles CA 90084-1163 Ph: (760) 776-8989 | Desert Medical Imaging 74785 Us Highway 111 Suite 101 Indian Wells CA 92210-7128 Ph: (760) 776-8989 |
| NPI Number | 1467506451 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 04/22/2022 |
| Medicare PECOS PAC ID | 7012806052 |
|---|---|
| Medicare Enrollment ID | O20040315001110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467506451 | NPI | - | NPPES |
| ZZZ02402Z | Other | CA | BLUE SHIELD PIN |
| ZZZ02402Z | Other | CA | BLUE CROSS |
| ZZZ64094Z | Other | CA | BLUE SHIELD PIN |
| ZZZ64094Z | Other | CA | BLUE CROSS |
| GR0083072 | Medicaid | CA | |
| GR0083073 | Medicaid | CA | |
| CK9031 | Other | CA | RAILROAD MEDICARE |
| ZZZ57290Z | Other | CA | BLUE SHIELD PIN |
| ZZZ05859Z | Other | CA | BLUE CROSS |
| ZZZ57290Z | Other | CA | BLUE CROSS |
| GR0083070 | Medicaid | CA | |
| GR0083071 | Medicaid | CA | |
| ZZZ05859Z | Other | CA | BLUE SHIELD PIN |
| Provider Name | Sydney L Stevens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053422279 PECOS PAC ID: 4082519533 Enrollment ID: I20050413001245 |
| Provider Name | John F Feller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114927050 PECOS PAC ID: 2567403470 Enrollment ID: I20050519001151 |
| Provider Name | Craig S Letner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477516805 PECOS PAC ID: 1759327760 Enrollment ID: I20050629001214 |
| Provider Name | Herman R Mcdaniel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063524130 PECOS PAC ID: 9335185180 Enrollment ID: I20050630001170 |
| Provider Name | Adam Brochert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033169339 PECOS PAC ID: 0547256331 Enrollment ID: I20050913001349 |
| Provider Name | Ragu C Nathan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467413344 PECOS PAC ID: 0547280638 Enrollment ID: I20060818000280 |
| Provider Name | Lisa M Bodon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063619013 PECOS PAC ID: 2668567009 Enrollment ID: I20071011000202 |
| Provider Name | Andrew B Harris |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174563399 PECOS PAC ID: 4688686520 Enrollment ID: I20071108000695 |
| Provider Name | Mauricio Schrader |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497792626 PECOS PAC ID: 0749192847 Enrollment ID: I20080811000551 |
| Provider Name | Mersedeh Karimian |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1952516304 PECOS PAC ID: 3678633880 Enrollment ID: I20081118000505 |
| Provider Name | Pedram Ilbeigi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1609827336 PECOS PAC ID: 2062424674 Enrollment ID: I20081205000510 |
| Provider Name | Iraj Nabi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1407950777 PECOS PAC ID: 8325196405 Enrollment ID: I20090429000219 |
| Provider Name | Patricia E Hadley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750393633 PECOS PAC ID: 3971651803 Enrollment ID: I20090504000452 |
| Provider Name | Rafal Sosnowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699941039 PECOS PAC ID: 5294889275 Enrollment ID: I20090811000523 |
| Provider Name | Jeffrey Herz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124091772 PECOS PAC ID: 3173660321 Enrollment ID: I20091021000435 |
| Provider Name | Nilofar Firooznia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962521419 PECOS PAC ID: 7719070895 Enrollment ID: I20100128000726 |
| Provider Name | Ramin Akhavan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861561300 PECOS PAC ID: 6103856893 Enrollment ID: I20100813000422 |
| Provider Name | Samuel S Lee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194772418 PECOS PAC ID: 5496828485 Enrollment ID: I20100910000977 |
| Provider Name | Christopher R Hancock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922128255 PECOS PAC ID: 8628167673 Enrollment ID: I20110511000220 |
| Provider Name | Sean Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801108568 PECOS PAC ID: 8325216518 Enrollment ID: I20110713000630 |
| Provider Name | Jonathan W Blevins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477710127 PECOS PAC ID: 0840463030 Enrollment ID: I20111103000556 |
| Provider Name | Stephen Michael Auerbach |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1811910649 PECOS PAC ID: 6204002702 Enrollment ID: I20120105000133 |
| Provider Name | Timmy M Joseph |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1669639175 PECOS PAC ID: 2365681343 Enrollment ID: I20130624000492 |
| Provider Name | Edmund Hong-sing Wong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336352335 PECOS PAC ID: 6800063041 Enrollment ID: I20140701000689 |
| Provider Name | Farshid Mirzaee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194969436 PECOS PAC ID: 8820214208 Enrollment ID: I20140721000790 |
| Provider Name | Paul A Baez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982654976 PECOS PAC ID: 4880628304 Enrollment ID: I20141218001161 |
| Provider Name | Nghi Lu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235467143 PECOS PAC ID: 9436472990 Enrollment ID: I20150108001694 |
| Provider Name | Cesar A Mora-esteves |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588857460 PECOS PAC ID: 2264758325 Enrollment ID: I20150307000194 |
| Provider Name | Lara S Bussey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851590061 PECOS PAC ID: 1052484128 Enrollment ID: I20150527002137 |
| Provider Name | David Nhat Tran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992930465 PECOS PAC ID: 7416188529 Enrollment ID: I20150603000973 |
| Provider Name | Natalie P Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952747925 PECOS PAC ID: 7416268677 Enrollment ID: I20150616000040 |
| Provider Name | Bobby S Alexander |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235575903 PECOS PAC ID: 9638485220 Enrollment ID: I20150827000490 |
| Provider Name | Crystal E May |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235475518 PECOS PAC ID: 8729356563 Enrollment ID: I20170619002750 |
| Provider Name | Steven R Gunberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902817810 PECOS PAC ID: 3274438668 Enrollment ID: I20171107001878 |
| Provider Name | Felipe Espinoza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942289376 PECOS PAC ID: 1153342621 Enrollment ID: I20180103002873 |
| Provider Name | Lorraine Rabadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548825953 PECOS PAC ID: 3173889086 Enrollment ID: I20190619003529 |
| Provider Name | Vladislav Bargman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1508951997 PECOS PAC ID: 3072584317 Enrollment ID: I20190711001991 |
| Provider Name | Saman Shafaat Talab |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1598185100 PECOS PAC ID: 5395070361 Enrollment ID: I20190712001524 |
| Provider Name | Arian Edwin Mashhood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629411061 PECOS PAC ID: 3870842081 Enrollment ID: I20190719000816 |
| Provider Name | Ashutosh Shelat |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851778096 PECOS PAC ID: 9739489345 Enrollment ID: I20200605000506 |
| Provider Name | Sloan Gordon |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1700881257 PECOS PAC ID: 9335119247 Enrollment ID: I20210521001411 |
| Provider Name | Catherine Marie Bianchi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164910147 PECOS PAC ID: 2466856323 Enrollment ID: I20210813003068 |
| Provider Name | Megan N Icole Baikie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205323110 PECOS PAC ID: 3072918960 Enrollment ID: I20210816000903 |
| Provider Name | Abdullah M Malkawi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043565500 PECOS PAC ID: 6800197401 Enrollment ID: I20230320002413 |
| Provider Name | Steven Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376981183 PECOS PAC ID: 2567726755 Enrollment ID: I20230718003659 |
| Provider Name | Zara Wadood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750813432 PECOS PAC ID: 1850662925 Enrollment ID: I20231201002230 |
Executive Urgent Care Centers Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 74785 Hwy 111, Suite 100, Indian Wells, CA 92210 Phone: 760-346-3939 | |
Ronald B Bush Md A Professional Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45-280 Club Dr, Indian Wells, CA 92210 Phone: 760-200-2992 | |
Daniel S Cosgrove, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45200 Club Dr Ste A, Indian Wells, CA 92210 Phone: 760-777-7698 Fax: 760-477-6002 | |
Welevate For Pain A Medical Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 45210 Club Dr, Indian Wells, CA 92210 Phone: 914-758-0044 Fax: 914-533-3568 |