Provider Demographics
NPI:1962600205
Name:RANCHO MIRAGE PSYCHIATRIC MEDICAL CENTER INC.
Entity type:Organization
Organization Name:RANCHO MIRAGE PSYCHIATRIC MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:ANNELI
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-776-6543
Mailing Address - Street 1:PO BOX 695
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-0695
Mailing Address - Country:US
Mailing Address - Phone:760-776-6543
Mailing Address - Fax:760-776-6546
Practice Address - Street 1:42525 RANCHO MIRAGE LN
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4312
Practice Address - Country:US
Practice Address - Phone:760-776-6543
Practice Address - Fax:760-776-6546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty