Provider Demographics
NPI:1023287364
Name:MABRY-HEIGHT, VICKIE YVONNE (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:VICKIE
Middle Name:YVONNE
Last Name:MABRY-HEIGHT
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-0542
Mailing Address - Country:US
Mailing Address - Phone:760-636-3393
Mailing Address - Fax:760-636-0257
Practice Address - Street 1:73241 HIGHWAY 111 STE 3D
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260
Practice Address - Country:US
Practice Address - Phone:760-636-4734
Practice Address - Fax:760-636-0257
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49812207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA954080495OtherIRS
CA954080495OtherIRS