SAIRWAA T. PREVOST, M.D., INC.
Osteopathic Medicine at Bob Hope Dr, Rancho Mirage, CA

License number
California C51315
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: DR. SAIRWAA TANDEE PREVOST M.D.
Title: MEDICAL DIRECTOR
Phone: (646) 489-3312
Address
Address 2
35400 Bob Hope Dr SUITE 107, Rancho Mirage, CA 92270
1400 E Tahquitz Canyon Way ROOM 323, Palm Springs, CA 92262
National Provider ID: 1114056538
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SAIRWAA T. PREVOST, M.D., INC

Rancho Mirage, CA

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Sairwaa T Prevost MD Inc
Registration:
Mar 7, 2007
Addresses:
35 400 Bob Hope Dr STE 107, Rancho Mirage, CA 92270 (Physical)
35400 Bob Hope Dr, Rancho Mirage, CA 92270
State ID:
C2914156
Business type:
Articles of Incorporation
President, Medical Director, Principal:
Sairwaa T. Prevost President, Medical Director, Principal, inactive
Agent:
Sairwaa T Prevost,Rancho Mirage, CA 92270 (Physical)

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