| Imperial County Physicians Medical Group Clinic | |
|
1503 N Imperial Ave Ste 105a El Centro CA 92243-6302 | |
| (760) 290-4297 | |
| Not Available |
| Full Name | Imperial County Physicians Medical Group Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1503 N Imperial Ave Ste 105a, El Centro, California |
| Authorized Official Name and Position | Mahomed Suliman (CEO) |
| Authorized Official Contact | 7603447976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imperial County Physicians Medical Group Clinic 1503 N Imperial Ave Ste 105a El Centro CA 92243-6302 Ph: (760) 290-4297 | Imperial County Physicians Medical Group Clinic 1503 N Imperial Ave Ste 105a El Centro CA 92243-6302 Ph: (760) 290-4297 |
| NPI Number | 1013516624 |
|---|---|
| Provider Enumeration Date | 10/23/2020 |
| Last Update Date | 10/23/2020 |
| Medicare PECOS PAC ID | 9032523949 |
|---|---|
| Medicare Enrollment ID | O20210203002211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013516624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Clara Padron-spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689693962 PECOS PAC ID: 9537136189 Enrollment ID: I20040913001226 |
| Provider Name | Mahomed Suliman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912994989 PECOS PAC ID: 8426007873 Enrollment ID: I20050112001193 |
| Provider Name | Mehboob Ghulam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215248273 PECOS PAC ID: 0244479954 Enrollment ID: I20130610000309 |
| Provider Name | Mayra Casillas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851174494 PECOS PAC ID: 1456791359 Enrollment ID: I20240425001397 |
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 | |
Legacy Md Medical Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1699 N Imperial Ave, El Centro, CA 92243 Phone: 760-550-1685 Fax: 888-631-5150 | |
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 | |