Provider Demographics
NPI:1386813004
Name:DESERT OASIS CLINIC
Entity type:Organization
Organization Name:DESERT OASIS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:L
Authorized Official - Last Name:FARINHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-446-2984
Mailing Address - Street 1:1041 N CHINA LAKE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3169
Mailing Address - Country:US
Mailing Address - Phone:760-446-2984
Mailing Address - Fax:760-446-2987
Practice Address - Street 1:1041 N CHINA LAKE BLVD STE A
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3169
Practice Address - Country:US
Practice Address - Phone:760-446-2984
Practice Address - Fax:760-446-2987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63404261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A634040OtherBLUE SHIELD
1122817OtherFIRST HEALTH NETWORK
5474655OtherAETNA
611724900OtherUS DEPT OF LABOR
11631144OtherCAQH
P00340424OtherRAILROAD MEDICARE
CA7098137Medicaid
G63714OtherUPIN
G63714OtherUPIN
G63714OtherUPIN