1134144165 NPI number — DAP HEALTH, INC.

Table of content: (NPI 1134144165)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134144165 NPI number — DAP HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAP HEALTH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DAP HEALTH-BORREGO SPRINGS COMMUNITY HEALTH CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134144165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1695 N. SUNRISE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-323-2118
Provider Business Mailing Address Fax Number:
760-767-4552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4343 YAQUI PASS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BORREGO SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92004-2369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-767-5051
Provider Business Practice Location Address Fax Number:
760-767-4552
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STITH
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Telephone Number:
760-323-2118

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  080000651 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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