| Will Family Medical Group, A Professional Corporation | |
|
42575 Washington St Palm Desert CA 92211-8850 | |
| (760) 360-0333 | |
| Not Available |
| Full Name | Will Family Medical Group, A Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 42575 Washington St, Palm Desert, California |
| Authorized Official Name and Position | Michael Lawrence Will (OWNER) |
| Authorized Official Contact | 9894667094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Will Family Medical Group, A Professional Corporation 42575 Washington St Palm Desert CA 92211-8850 Ph: (760) 360-0333 | Will Family Medical Group, A Professional Corporation 42575 Washington St Palm Desert CA 92211-8850 Ph: (760) 360-0333 |
| NPI Number | 1356875157 |
|---|---|
| Provider Enumeration Date | 04/18/2017 |
| Last Update Date | 04/12/2024 |
| Medicare PECOS PAC ID | 5193095115 |
|---|---|
| Medicare Enrollment ID | O20170725002020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356875157 | NPI | - | NPPES |
| A136246 | Other | CA | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A136246 (California) | Primary |
| Provider Name | Lawrence A Mora |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205851615 PECOS PAC ID: 6305820846 Enrollment ID: I20040614001239 |
| Provider Name | Frank T Kerrigan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730155730 PECOS PAC ID: 3476620899 Enrollment ID: I20080926000239 |
| Provider Name | Dzenan Lulic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356503791 PECOS PAC ID: 7517193816 Enrollment ID: I20131114001591 |
| Provider Name | Michael Lawrence Will |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073876090 PECOS PAC ID: 6507096617 Enrollment ID: I20150717000676 |
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