| Imperial Valley Family Care Medical Group, Apc | |
|
608 G St Suite 1a Brawley CA 92227-2568 | |
| (760) 351-1011 | |
| (760) 545-0247 |
| Full Name | Imperial Valley Family Care Medical Group, Apc |
|---|---|
| Speciality | Clinic/Center |
| Location | 608 G St, Brawley, California |
| Authorized Official Name and Position | Vachaspathi Palakodeti (PRESIDENT) |
| Authorized Official Contact | 7603557730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imperial Valley Family Care Medical Group, Apc 516 W Aten Rd Suite 2 Imperial CA 92251-9805 Ph: (760) 355-7730 | Imperial Valley Family Care Medical Group, Apc 608 G St Suite 1a Brawley CA 92227-2568 Ph: (760) 351-1011 |
| NPI Number | 1508295502 |
|---|---|
| Provider Enumeration Date | 11/11/2013 |
| Last Update Date | 11/20/2013 |
| Medicare PECOS PAC ID | 0446243083 |
|---|---|
| Medicare Enrollment ID | O20140221000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508295502 | NPI | - | NPPES |
| GR0066310 | Medicaid | CA | |
| GR0066318 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (California) | Primary |
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