| Innercare | |
|
852 E Danenberg Dr. El Centro CA 92243 | |
| (760) 344-9951 | |
| (760) 344-5840 |
| Full Name | Innercare |
|---|---|
| Speciality | Clinic/Center |
| Location | 852 E Danenberg Dr., El Centro, California |
| Authorized Official Name and Position | Yvonne Bell (CEO) |
| Authorized Official Contact | 7603449951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innercare 852 E Danenberg Dr. El Centro CA 92243 Ph: (760) 344-9951 | Innercare 852 E Danenberg Dr. El Centro CA 92243 Ph: (760) 344-9951 |
| NPI Number | 1346313889 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 02/18/2022 |
| Medicare PECOS PAC ID | 5496657082 |
|---|---|
| Medicare Enrollment ID | O20071201000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346313889 | NPI | - | NPPES |
| 1356424212 | Other | NPPES | |
| 1649269747 | Other | NPPES | |
| 1699859421 | Other | NPI | |
| 1962599266 | Other | NPPES | |
| 1124115431 | Other | NPPES | |
| 1023188687 | Other | NPPES | |
| 1124109202 | Other | NPPES | |
| 1487741773 | Other | NPPES | |
| 1679654750 | Other | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Frederic Butler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801896907 PECOS PAC ID: 9133033319 Enrollment ID: I20031113000303 |
| Provider Name | Cyril M Gostich |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821118282 PECOS PAC ID: 1153223243 Enrollment ID: I20040608000878 |
| Provider Name | Jose-daniel Hernandez Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487702379 PECOS PAC ID: 8426031014 Enrollment ID: I20040612000799 |
| Provider Name | Dana Marie Lewis |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1396717013 PECOS PAC ID: 6305813528 Enrollment ID: I20040915001140 |
| Provider Name | Martha N Adigwe-mozia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225186133 PECOS PAC ID: 5799745204 Enrollment ID: I20041018001274 |
| Provider Name | Bushra F Ahmad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043356850 PECOS PAC ID: 8628035789 Enrollment ID: I20041210000433 |
| Provider Name | Francesca A. Flowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801839675 PECOS PAC ID: 4183682313 Enrollment ID: I20041220001044 |
| Provider Name | Jacqueline Sevilla |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518023209 PECOS PAC ID: 8123071677 Enrollment ID: I20050224000902 |
| Provider Name | Stephen E Gocke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548351513 PECOS PAC ID: 6002864675 Enrollment ID: I20050401000996 |
| Provider Name | Mary Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023191582 PECOS PAC ID: 5294782165 Enrollment ID: I20050401001010 |
| Provider Name | Sanjay M Vaswani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982752952 PECOS PAC ID: 2163459991 Enrollment ID: I20050722000428 |
| Provider Name | Kenneth G Lucero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417079989 PECOS PAC ID: 7113947060 Enrollment ID: I20070605000594 |
| Provider Name | Dennis B Alters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457371635 PECOS PAC ID: 7618060393 Enrollment ID: I20070911000896 |
| Provider Name | Randolph D Gibbs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487859294 PECOS PAC ID: 6305829177 Enrollment ID: I20070926001077 |
| Provider Name | Afshan N Baig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417028630 PECOS PAC ID: 4880783695 Enrollment ID: I20071201000178 |
| Provider Name | Juan Carlos Velazquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497812895 PECOS PAC ID: 2961591771 Enrollment ID: I20071201000200 |
| Provider Name | Susan V Bravo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689881310 PECOS PAC ID: 2365516614 Enrollment ID: I20080804000585 |
| Provider Name | Edward M Zabrek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699828939 PECOS PAC ID: 7315006681 Enrollment ID: I20081103000042 |
| Provider Name | Bradley S Walker |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194783530 PECOS PAC ID: 6709899966 Enrollment ID: I20090204000390 |
| Provider Name | Man C Duong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679718399 PECOS PAC ID: 4981755832 Enrollment ID: I20090706000499 |
| Provider Name | Michael L Hoffman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720047707 PECOS PAC ID: 8527077767 Enrollment ID: I20091007000748 |
| Provider Name | Issadora Lara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306007042 PECOS PAC ID: 0547391203 Enrollment ID: I20100624000987 |
| Provider Name | Thomas Teske |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447259965 PECOS PAC ID: 6709072358 Enrollment ID: I20101122001385 |
| Provider Name | Vicenta Anque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295707743 PECOS PAC ID: 7517140569 Enrollment ID: I20110329000261 |
| Provider Name | Sheri Wen Hsu |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1831300722 PECOS PAC ID: 8527237841 Enrollment ID: I20110803000109 |
| Provider Name | Veerinder S Anand |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881613420 PECOS PAC ID: 3173502754 Enrollment ID: I20111222000563 |
| Provider Name | Maria G Chavez-brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073873626 PECOS PAC ID: 7517120538 Enrollment ID: I20120531000182 |
| Provider Name | Aalamgeer Ibrahim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386838795 PECOS PAC ID: 1153578893 Enrollment ID: I20120830000738 |
| Provider Name | Maria C Court |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316196108 PECOS PAC ID: 3577701994 Enrollment ID: I20130524000201 |
| Provider Name | Lisa M Bean |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760782817 PECOS PAC ID: 5092943787 Enrollment ID: I20131231001042 |
| Provider Name | Allan Y Wu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265538912 PECOS PAC ID: 0042100422 Enrollment ID: I20140508002045 |
| Provider Name | Jessica L Thackaberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134478910 PECOS PAC ID: 4082831110 Enrollment ID: I20140813000175 |
| Provider Name | Javier Hernandez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144318734 PECOS PAC ID: 2668693656 Enrollment ID: I20141015002455 |
| Provider Name | Salvador Vallarta |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083700884 PECOS PAC ID: 9133442734 Enrollment ID: I20150107001411 |
| Provider Name | Omolade A Ogun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548526494 PECOS PAC ID: 9638494503 Enrollment ID: I20150217001933 |
| Provider Name | Jose Navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710371794 PECOS PAC ID: 0749500478 Enrollment ID: I20150521000094 |
| Provider Name | Roberto Castanos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184914970 PECOS PAC ID: 5395066286 Enrollment ID: I20150603002887 |
| Provider Name | Dale T Ello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215329099 PECOS PAC ID: 4486962560 Enrollment ID: I20151009001752 |
| Provider Name | Salvador Ortega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639429871 PECOS PAC ID: 8820391592 Enrollment ID: I20160129001914 |
| Provider Name | Mayra K Carboni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508240862 PECOS PAC ID: 7911206776 Enrollment ID: I20160428001375 |
| Provider Name | Uri Guefen |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275646333 PECOS PAC ID: 2668373747 Enrollment ID: I20160629000934 |
| Provider Name | Avelina T Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043612013 PECOS PAC ID: 0042507824 Enrollment ID: I20160921002719 |
| Provider Name | Kacie G Brumley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518333483 PECOS PAC ID: 7911288311 Enrollment ID: I20161222001389 |
| Provider Name | Andre T Dejean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639140700 PECOS PAC ID: 6608810130 Enrollment ID: I20170104001095 |
| Provider Name | Molly Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275921264 PECOS PAC ID: 1355623430 Enrollment ID: I20170125001549 |
| Provider Name | Brenda Bebal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336508506 PECOS PAC ID: 3375831910 Enrollment ID: I20170424000429 |
| Provider Name | Kathleen A Sharpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831551035 PECOS PAC ID: 4082912704 Enrollment ID: I20170619000911 |
| Provider Name | Oscar Aguilar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740325745 PECOS PAC ID: 5496024341 Enrollment ID: I20170707002635 |
| Provider Name | Luc O Fontaine |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629000724 PECOS PAC ID: 8527355122 Enrollment ID: I20170810001687 |
| Provider Name | Michelle L Melendez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851457725 PECOS PAC ID: 1557508256 Enrollment ID: I20170810003667 |
| Provider Name | Eugene J Basiliere |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518929876 PECOS PAC ID: 1850600123 Enrollment ID: I20170814002295 |
| Provider Name | Saune-elisabet Carlisle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023274040 PECOS PAC ID: 0042486144 Enrollment ID: I20170815002273 |
| Provider Name | Victor Ruiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619097730 PECOS PAC ID: 7618162280 Enrollment ID: I20170816004658 |
| Provider Name | Owais Ahmad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427461532 PECOS PAC ID: 1153694609 Enrollment ID: I20170905000783 |
| Provider Name | Cheryl Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548643166 PECOS PAC ID: 4981913191 Enrollment ID: I20170911003169 |
| Provider Name | Mayahuel S Valle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811366123 PECOS PAC ID: 6608154414 Enrollment ID: I20170912002122 |
| Provider Name | Marietta C Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477610855 PECOS PAC ID: 6709024391 Enrollment ID: I20170913000014 |
| Provider Name | Mary S Buffington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699858472 PECOS PAC ID: 5294808085 Enrollment ID: I20170913000063 |
| Provider Name | Barbara Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811054315 PECOS PAC ID: 0547408122 Enrollment ID: I20170913001426 |
| Provider Name | Rene Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255669438 PECOS PAC ID: 6507136561 Enrollment ID: I20170914000900 |
| Provider Name | Elpidio V Querubin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528483146 PECOS PAC ID: 2264737303 Enrollment ID: I20170920002088 |
| Provider Name | Denisse Morales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881851384 PECOS PAC ID: 6103190608 Enrollment ID: I20170921003649 |
| Provider Name | Leon Yan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962569228 PECOS PAC ID: 6002056587 Enrollment ID: I20171002002162 |
| Provider Name | Mohsen Shalaby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366642522 PECOS PAC ID: 1254579410 Enrollment ID: I20171003005448 |
| Provider Name | Saima Khan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205993623 PECOS PAC ID: 0244478873 Enrollment ID: I20171006001876 |
| Provider Name | Kimberly Calderon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932332608 PECOS PAC ID: 8527372291 Enrollment ID: I20171006002346 |
| Provider Name | An Thuy Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942680533 PECOS PAC ID: 5799051900 Enrollment ID: I20171016001769 |
| Provider Name | Talia Luc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861926198 PECOS PAC ID: 7113286303 Enrollment ID: I20180116000838 |
| Provider Name | Solange Pierre Michel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619023157 PECOS PAC ID: 5092810283 Enrollment ID: I20180116001944 |
| Provider Name | Vanessa A Hernandez |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1699115386 PECOS PAC ID: 7416252101 Enrollment ID: I20180118000041 |
| Provider Name | Elizabeth Sears-wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215394382 PECOS PAC ID: 0648530949 Enrollment ID: I20180206001454 |
| Provider Name | Karima Akinpelu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700015153 PECOS PAC ID: 0345502076 Enrollment ID: I20180316002031 |
| Provider Name | Ashu Garg |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1558627174 PECOS PAC ID: 5193085371 Enrollment ID: I20180329002182 |
| Provider Name | Gloria A Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932519964 PECOS PAC ID: 0244506764 Enrollment ID: I20180403001738 |
| Provider Name | Alexander T Sykora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427556596 PECOS PAC ID: 7719247618 Enrollment ID: I20180403002686 |
| Provider Name | Richard J Eppey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902112782 PECOS PAC ID: 7810241437 Enrollment ID: I20181119001663 |
| Provider Name | Ricardo F Villalba Lopez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407101009 PECOS PAC ID: 5597071472 Enrollment ID: I20190116001758 |
| Provider Name | Maria Bueno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821155185 PECOS PAC ID: 2668600917 Enrollment ID: I20190116002892 |
| Provider Name | Patricia R Mccallister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508069071 PECOS PAC ID: 6901041888 Enrollment ID: I20190306002035 |
| Provider Name | Abimbola Dtonye Iketubosin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356841514 PECOS PAC ID: 6709129554 Enrollment ID: I20190517000285 |
| Provider Name | Joann Smith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1336586999 PECOS PAC ID: 2163756206 Enrollment ID: I20190625000267 |
| Provider Name | Kristin T Tang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053775015 PECOS PAC ID: 5890021513 Enrollment ID: I20190801001573 |
| Provider Name | Amy N Dao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891350997 PECOS PAC ID: 0941539449 Enrollment ID: I20190909002806 |
| Provider Name | Patrick Hieu Dao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538723622 PECOS PAC ID: 9436488798 Enrollment ID: I20190916001749 |
| Provider Name | Barbara Jane Wallner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548344856 PECOS PAC ID: 7012217433 Enrollment ID: I20191003001693 |
| Provider Name | Rashidat T Boyejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295238350 PECOS PAC ID: 3779815253 Enrollment ID: I20191101002502 |
| Provider Name | Abraham A Vandiver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982176947 PECOS PAC ID: 2860826062 Enrollment ID: I20191220002460 |
| Provider Name | Jeffery J Zielinski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326273244 PECOS PAC ID: 9830524461 Enrollment ID: I20200108002274 |
| Provider Name | Diana Pulido Martil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366959165 PECOS PAC ID: 9739440595 Enrollment ID: I20200115002658 |
| Provider Name | Mehyo Tabikh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699126078 PECOS PAC ID: 7416388483 Enrollment ID: I20200506001618 |
| Provider Name | Angela C Rachal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386959351 PECOS PAC ID: 0244425940 Enrollment ID: I20200901001484 |
| Provider Name | Francisco Ordaz-chavez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881171148 PECOS PAC ID: 1355761263 Enrollment ID: I20201014003683 |
| Provider Name | Emiliano S Higuera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023344660 PECOS PAC ID: 5496907271 Enrollment ID: I20201022002591 |
| Provider Name | Saifuddin Talib |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205266947 PECOS PAC ID: 5698994200 Enrollment ID: I20201029001950 |
| Provider Name | Dae Yong Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679094981 PECOS PAC ID: 5597009563 Enrollment ID: I20201110001796 |
| Provider Name | Mirza H Beg |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1710183066 PECOS PAC ID: 0840383899 Enrollment ID: I20201123000625 |
| Provider Name | Gladys Valdez Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861923492 PECOS PAC ID: 8022447085 Enrollment ID: I20201201003249 |
| Provider Name | Joseph John Loyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952904831 PECOS PAC ID: 4183036114 Enrollment ID: I20201216002704 |
| Provider Name | Elaine M Archuleta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295973287 PECOS PAC ID: 6800209297 Enrollment ID: I20201231001801 |
| Provider Name | Amindeep Lail |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356883953 PECOS PAC ID: 1254746639 Enrollment ID: I20210217000516 |
| Provider Name | Hussein A Hijazi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356737191 PECOS PAC ID: 6507128808 Enrollment ID: I20210503002750 |
| Provider Name | Akashdeep Dhaliwal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710411954 PECOS PAC ID: 0446652754 Enrollment ID: I20210708003593 |
| Provider Name | Leslie M Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659959278 PECOS PAC ID: 3971908062 Enrollment ID: I20210827001648 |
| Provider Name | Valentin Nuzhny |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1760918734 PECOS PAC ID: 5496150419 Enrollment ID: I20210828000413 |
| Provider Name | Lisa Rosa-re |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336244896 PECOS PAC ID: 1557369949 Enrollment ID: I20211006001003 |
| Provider Name | Wesley E Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265032486 PECOS PAC ID: 9537557392 Enrollment ID: I20211027001645 |
| Provider Name | Frederick Afari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174010169 PECOS PAC ID: 0648678847 Enrollment ID: I20211101000982 |
| Provider Name | Delia V Valenzuela |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992184642 PECOS PAC ID: 8022401652 Enrollment ID: I20220203000928 |
| Provider Name | Tyrone M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548729080 PECOS PAC ID: 4880922541 Enrollment ID: I20220214001016 |
| Provider Name | B'lala Nawurah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801325360 PECOS PAC ID: 6507100559 Enrollment ID: I20220218001998 |
| Provider Name | Mayra Robinson Herasme |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851797328 PECOS PAC ID: 4385910967 Enrollment ID: I20220411002396 |
| Provider Name | Rodolfo J Mercado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356890248 PECOS PAC ID: 1951782069 Enrollment ID: I20220721000290 |
| Provider Name | Juanita I Jalomo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053714360 PECOS PAC ID: 3870840390 Enrollment ID: I20220726002497 |
| Provider Name | Mary Joan D Gidor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720277288 PECOS PAC ID: 8527353762 Enrollment ID: I20220728000761 |
| Provider Name | Veronica C Landeros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477782852 PECOS PAC ID: 2466834437 Enrollment ID: I20220808001922 |
| Provider Name | Khashayar Ebrahimzadeh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770144016 PECOS PAC ID: 8921484031 Enrollment ID: I20220927002146 |
| Provider Name | Tatyana Armstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538620133 PECOS PAC ID: 8224370051 Enrollment ID: I20221115001268 |
| Provider Name | Dulce I Mayoral Cinco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306584404 PECOS PAC ID: 2062880842 Enrollment ID: I20221129001815 |
| Provider Name | Prasanna Bastola |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831750306 PECOS PAC ID: 6800265802 Enrollment ID: I20221214001887 |
| Provider Name | Khyle A Pearson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770291346 PECOS PAC ID: 4486024007 Enrollment ID: I20221222002245 |
| Provider Name | Mona Lisa Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720744162 PECOS PAC ID: 4981077385 Enrollment ID: I20230306002680 |
| Provider Name | Gerardo J Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194430165 PECOS PAC ID: 3678946779 Enrollment ID: I20230309002322 |
| Provider Name | Nadia Torres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851421671 PECOS PAC ID: 5193190262 Enrollment ID: I20230404001696 |
| Provider Name | Ruth Perry |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356884795 PECOS PAC ID: 2668847567 Enrollment ID: I20230406001117 |
| Provider Name | Omar A Aziz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548662182 PECOS PAC ID: 6709185747 Enrollment ID: I20230504002750 |
| Provider Name | Eric B Mendoza |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033633136 PECOS PAC ID: 9133581507 Enrollment ID: I20230816003859 |
| Provider Name | David Sea Jong Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740849066 PECOS PAC ID: 3375998842 Enrollment ID: I20231018003508 |
| Provider Name | Jaime S Dominguez |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508837980 PECOS PAC ID: 3173962412 Enrollment ID: I20240418002928 |
| Provider Name | Peta Gay S Bezek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396281911 PECOS PAC ID: 4284901372 Enrollment ID: I20240507000176 |
| Provider Name | Gabrielle Clayton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245098300 PECOS PAC ID: 3971944935 Enrollment ID: I20240508003686 |
El Centro Hospital Based Physician Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Ross Ave, El Centro, CA 92243 Phone: 760-339-7100 Fax: 760-339-7389 | |
Imperial County Physicians Medical Group Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1503 N Imperial Ave Ste 105a, El Centro, CA 92243 Phone: 760-290-4297 | |
Imperial County Public Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 935 Broadway Ave, El Centro, CA 92243 Phone: 442-265-1444 Fax: 760-352-9933 | |
Easyaccess Care Ipa, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1590 S Imperial Ave, El Centro, CA 92243 Phone: 760-352-2551 Fax: 760-352-3022 | |
Ceja & Singh A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2061 Ross Ave Ste B, El Centro, CA 92243 Phone: 603-525-8007 | |
El Centro Outpatient Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 385 W Main St, El Centro, CA 92243 Phone: 760-482-9100 | |
Imperial County Physicians Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1498 S La Brucherie Rd, El Centro, CA 92243 Phone: 858-775-5553 Fax: 858-824-7010 |