Provider Demographics
NPI:1902847486
Name:STANSELL, JOHN DEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DEE
Last Name:STANSELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4791 E PALM CANYON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-5220
Mailing Address - Country:US
Mailing Address - Phone:760-834-7950
Mailing Address - Fax:
Practice Address - Street 1:4791 E PALM CANYON DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-5220
Practice Address - Country:US
Practice Address - Phone:760-834-7950
Practice Address - Fax:760-834-7951
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG58967207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00387055OtherMEDICARE RAILROAD
P00387055OtherMEDICARE RAILROAD
CA00G589672Medicare PIN