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1001 Blair Ave Calexico CA 92231-2308 | |
| (760) 562-6633 | |
| (760) 768-5037 |
| Full Name | |
|---|---|
| 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 |
|---|---|
1001 Blair Ave Calexico CA 92231-2308 Ph: (760) 562-6633 | 1001 Blair Ave Calexico CA 92231-2308 Ph: (760) 562-6633 |
| NPI Number | 1356524599 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 03/11/2008 |
| Medicare PECOS PAC ID | 2163507674 |
|---|---|
| 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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