| Clinicas Del Valle A Professional Corp | |
|
120 W Cole Blvd Ste B Calexico CA 92231-9700 | |
| (760) 890-0190 | |
| (760) 890-0160 |
| Full Name | Clinicas Del Valle A Professional Corp |
|---|---|
| Speciality | Pain Medicine |
| Location | 120 W Cole Blvd Ste B, Calexico, California |
| Authorized Official Name and Position | Paulin Vega (CFO) |
| Authorized Official Contact | 7608900190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinicas Del Valle A Professional Corp 120 W Cole Blvd Ste B Calexico CA 92231-9700 Ph: (760) 890-0190 | Clinicas Del Valle A Professional Corp 120 W Cole Blvd Ste B Calexico CA 92231-9700 Ph: (760) 890-0190 |
| NPI Number | 1184292179 |
|---|---|
| Provider Enumeration Date | 06/15/2021 |
| Last Update Date | 10/05/2021 |
| Medicare PECOS PAC ID | 9436557428 |
|---|---|
| Medicare Enrollment ID | O20211005002669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184292179 | NPI | - | NPPES |
| 1912512567 | Other | CA | NPI |
| 10939837 | Other | CA | CAQH |
| Provider Name | Robert A Kleiman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639132640 PECOS PAC ID: 2961305131 Enrollment ID: I20040127001089 |
| Provider Name | John E Bohm |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992771604 PECOS PAC ID: 5991720112 Enrollment ID: I20060213000448 |
| Provider Name | Khalid B Ahmed |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134193923 PECOS PAC ID: 7113913724 Enrollment ID: I20120418000317 |
| Provider Name | Juliet E Fliegel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295936201 PECOS PAC ID: 6507092194 Enrollment ID: I20131204002017 |
| Provider Name | Salvador Ortega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639429871 PECOS PAC ID: 8820391592 Enrollment ID: I20160129001914 |
| Provider Name | Sarah Udor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861013575 PECOS PAC ID: 4789006057 Enrollment ID: I20200616001036 |
| Provider Name | Chip Booher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841617529 PECOS PAC ID: 8921416207 Enrollment ID: I20210427000594 |
| Provider Name | Iliana Gomez-ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265183024 PECOS PAC ID: 8123476777 Enrollment ID: I20231121001414 |
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