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495 E Birch St Ste A Calexico CA 92231-2374 | |
| (760) 357-0508 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 495 E Birch St Ste A, Calexico, California |
| Authorized Official Name and Position | Tisha Irene Benavidez (PATIENT FINANCIAL SERVICES DIRECTOR) |
| Authorized Official Contact | 7604825334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1415 Ross Ave El Centro CA 92243-4306 Ph: (760) 339-7495 | 495 E Birch St Ste A Calexico CA 92231-2374 Ph: (760) 357-0508 |
| NPI Number | 1598840258 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 02/07/2019 |
| Medicare PECOS PAC ID | 6901986397 |
|---|---|
| Medicare Enrollment ID | O20100513000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598840258 | NPI | - | NPPES |
| RHM18536F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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