| Imperial Valley Hospitalist Inc | |
|
207 W Legion Rd Brawley CA 92227-7780 | |
| (760) 344-7976 | |
| (760) 344-7106 |
| Full Name | Imperial Valley Hospitalist Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 207 W Legion Rd, Brawley, California |
| Authorized Official Name and Position | Michael N Krutzik (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 Valley Hospitalist Inc 605 W H St Ste 110 Brawley CA 92227-2250 Ph: (760) 344-7976 | Imperial Valley Hospitalist Inc 207 W Legion Rd Brawley CA 92227-7780 Ph: (760) 344-7976 |
| NPI Number | 1316446644 |
|---|---|
| Provider Enumeration Date | 02/01/2018 |
| Last Update Date | 02/01/2018 |
| Medicare PECOS PAC ID | 9335401231 |
|---|---|
| Medicare Enrollment ID | O20180312001942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316446644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael N Krutzik |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447290168 PECOS PAC ID: 1456246255 Enrollment ID: I20040219000915 |
| Provider Name | Brian M Tyson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346266269 PECOS PAC ID: 7517921067 Enrollment ID: I20041115001272 |
| Provider Name | Nii Aryee E Tetteh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528080041 PECOS PAC ID: 7012957897 Enrollment ID: I20050511000474 |
| Provider Name | George C Fareed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720074313 PECOS PAC ID: 6709813017 Enrollment ID: I20050719000478 |
| Provider Name | Victor Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134367204 PECOS PAC ID: 1254497332 Enrollment ID: I20090226000196 |
| Provider Name | Man C Duong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679718399 PECOS PAC ID: 4981755832 Enrollment ID: I20090706000499 |
| Provider Name | Hossein Ebneshahidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265661953 PECOS PAC ID: 6507903572 Enrollment ID: I20091023000114 |
| Provider Name | Bhuwan Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528096534 PECOS PAC ID: 3779636360 Enrollment ID: I20091211000503 |
| Provider Name | Michael N Rutman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245303122 PECOS PAC ID: 2860533056 Enrollment ID: I20100111000198 |
| Provider Name | Lewis Self |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942368907 PECOS PAC ID: 9234114455 Enrollment ID: I20121206000117 |
| Provider Name | Mehboob Ghulam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215248273 PECOS PAC ID: 0244479954 Enrollment ID: I20130610000309 |
| Provider Name | James Yc Tang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508151127 PECOS PAC ID: 8022238468 Enrollment ID: I20141006002522 |
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