| Life Connect Medical, Inc | |
|
35900 Bob Hope Dr Suite # 100 Rancho Mirage CA 92270-1766 | |
| (760) 699-7117 | |
| (760) 699-7750 |
| Full Name | Life Connect Medical, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 35900 Bob Hope Dr, Rancho Mirage, California |
| Authorized Official Name and Position | Padma Khanchustambahm (OWNER) |
| Authorized Official Contact | 7604642166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Connect Medical, Inc 36101 Bob Hope Dr Ste. E-5 #117 Rancho Mirage CA 92270-2001 Ph: (760) 217-0126 | Life Connect Medical, Inc 35900 Bob Hope Dr Suite # 100 Rancho Mirage CA 92270-1766 Ph: (760) 699-7117 |
| NPI Number | 1245489384 |
|---|---|
| Provider Enumeration Date | 09/12/2008 |
| Last Update Date | 05/03/2016 |
| Medicare PECOS PAC ID | 7416017751 |
|---|---|
| Medicare Enrollment ID | O20081117000684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245489384 | NPI | - | NPPES |
| AV186 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A86478 (California) | Primary |
| Provider Name | Padma Khanchustambham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245243146 PECOS PAC ID: 8325077944 Enrollment ID: I20050804000382 |
| Provider Name | Sofia Peterson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386664498 PECOS PAC ID: 1456436476 Enrollment ID: I20080313000734 |
| Provider Name | Wanda K. Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003456609 PECOS PAC ID: 9537597976 Enrollment ID: I20200317001775 |
Concept Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35400 Bob Hope Dr, Suite # 209, Rancho Mirage, CA 92270 Phone: 760-699-7117 Fax: 760-699-7750 | |
Mary A Howell Md A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 39000 Bob Hope Dr, #p317, Rancho Mirage, CA 92270 Phone: 760-340-3611 Fax: 760-340-2252 | |
R Jeffrey Heilpern Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39700 Bob Hope Drive, Suite 110, Rancho Mirage, CA 92270 Phone: 760-340-5545 Fax: 760-346-6208 | |
Cambridge Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35400 Bob Hope Dr, #102, Rancho Mirage, CA 92270 Phone: 760-972-6060 Fax: 702-492-1728 | |
Age Right Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35400 Bob Hope Dr, Suite 107, Rancho Mirage, CA 92270 Phone: 646-489-3312 | |
Tarleton Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 39000 Bob Hope Drive, Suite K406, Rancho Mirage, CA 92270 Phone: 760-836-0708 Fax: 760-776-4293 | |
360 Wellness Solutions Physical Therapy And Rehabilitation Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 194 Loch Lomond Rd, Rancho Mirage, CA 92270 Phone: 760-832-8025 |