De Anza Clinic | |
1001 Blair Ave Calexico CA 92231-2308 | |
(760) 562-6633 | |
(760) 768-5037 |
Full Name | De Anza Clinic |
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Speciality | Clinic/Center |
Location | 1001 Blair Ave, Calexico, California |
Authorized Official Name and Position | Mervat G. Kelada (ADMINISTRATOR) |
Authorized Official Contact | 7605626633 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
De Anza Clinic 1001 Blair Ave Calexico CA 92231-2308 Ph: (760) 562-6633 | De Anza Clinic 1001 Blair Ave Calexico CA 92231-2308 Ph: (760) 562-6633 |
NPI Number | 1356524599 |
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Provider Enumeration Date | 12/11/2007 |
Last Update Date | 03/11/2008 |
Medicare PECOS PAC ID | 2163507674 |
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Medicare Enrollment ID | O20080307000518 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356524599 | NPI | - | NPPES |
RHM53866F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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