Provider Demographics
NPI:1487973897
Name:DESERT VIEW PEDIATRIC NIGHT CLINIC
Entity type:Organization
Organization Name:DESERT VIEW PEDIATRIC NIGHT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-838-0100
Mailing Address - Street 1:3901 N MESA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902
Mailing Address - Country:US
Mailing Address - Phone:915-838-0100
Mailing Address - Fax:915-838-0122
Practice Address - Street 1:11410 VISTA DEL SOL STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-633-8171
Practice Address - Fax:915-838-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty