Provider Demographics
NPI:1487732590
Name:DESERT HYPERBARICS, LLC.
Entity type:Organization
Organization Name:DESERT HYPERBARICS, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIMELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-773-3899
Mailing Address - Street 1:36923 COOK ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6073
Mailing Address - Country:US
Mailing Address - Phone:760-773-3899
Mailing Address - Fax:760-773-5030
Practice Address - Street 1:36923 COOK ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6073
Practice Address - Country:US
Practice Address - Phone:760-773-3899
Practice Address - Fax:760-773-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABQ871AMedicare PIN