Legacy Md Medical Group Inc | |
1699 N Imperial Ave El Centro CA 92243-1320 | |
(760) 550-1685 | |
(888) 631-5150 |
Full Name | Legacy Md Medical Group Inc |
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Speciality | General Practice |
Location | 1699 N Imperial Ave, El Centro, California |
Authorized Official Name and Position | John M Strong (PRESIDENT) |
Authorized Official Contact | 7605501685 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Legacy Md Medical Group Inc 1699 N Imperial Ave El Centro CA 92243-1320 Ph: (760) 550-1685 | Legacy Md Medical Group Inc 1699 N Imperial Ave El Centro CA 92243-1320 Ph: (760) 550-1685 |
NPI Number | 1073210753 |
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Provider Enumeration Date | 02/13/2023 |
Last Update Date | 01/08/2025 |
Medicare PECOS PAC ID | 0446619738 |
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Medicare Enrollment ID | O20230705001455 |
Identifier | Type | State | Issuer |
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1073210753 | NPI | - | NPPES |
1043248719 | Other | CA | NPI |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Harry D Elshire |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1376618389 PECOS PAC ID: 2163410721 Enrollment ID: I20040506000442 |
Provider Name | Ramaiah Indudhara |
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Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1538116215 PECOS PAC ID: 7618957333 Enrollment ID: I20040722001405 |
Provider Name | Hoang M Ho |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1275684847 PECOS PAC ID: 7214906759 Enrollment ID: I20040930000689 |
Provider Name | Lawrence N Cooper |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1518939297 PECOS PAC ID: 4284603267 Enrollment ID: I20050418001321 |
Provider Name | Juan Carlos Velazquez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497812895 PECOS PAC ID: 2961591771 Enrollment ID: I20071201000200 |
Provider Name | Hetal R Bhakta |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1336248285 PECOS PAC ID: 4284718024 Enrollment ID: I20080303000619 |
Provider Name | Michael N Rutman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1245303122 PECOS PAC ID: 2860533056 Enrollment ID: I20100111000198 |
Provider Name | Bryant Nguyen |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1902085426 PECOS PAC ID: 4789756545 Enrollment ID: I20110815000304 |
Provider Name | James M Kohan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063568947 PECOS PAC ID: 1658364302 Enrollment ID: I20120104000377 |
Provider Name | Christopher Lai |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1508905159 PECOS PAC ID: 5193638328 Enrollment ID: I20120316000119 |
Provider Name | William Dechavez Convalecer |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1699794594 PECOS PAC ID: 5991709669 Enrollment ID: I20130828000859 |
Provider Name | John J Lee |
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Provider Type | Practitioner - Vascular Surgery |
Provider Identifiers | NPI Number: 1932356177 PECOS PAC ID: 1951612647 Enrollment ID: I20150622002362 |
Provider Name | Duc T Nguyen |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1245495498 PECOS PAC ID: 8527115815 Enrollment ID: I20160222000135 |
Provider Name | Patrick H Sweet |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457407702 PECOS PAC ID: 6901103829 Enrollment ID: I20160321001230 |
Provider Name | John Strong |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1043248719 PECOS PAC ID: 9335204163 Enrollment ID: I20170420001379 |
Provider Name | Sohaib Tariq |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1023391166 PECOS PAC ID: 6406124379 Enrollment ID: I20170616002455 |
Provider Name | Anh Ryuken Vo |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1699136127 PECOS PAC ID: 6709184930 Enrollment ID: I20190117002705 |
Provider Name | Alexis L Arreola |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760035992 PECOS PAC ID: 4385076751 Enrollment ID: I20191125000234 |
Provider Name | Christian Omar Romero |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942806237 PECOS PAC ID: 2567878408 Enrollment ID: I20210301002401 |
Provider Name | Jhoana B Tovar |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649868191 PECOS PAC ID: 8224445440 Enrollment ID: I20210405001923 |
Provider Name | Joanna Falcon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689254039 PECOS PAC ID: 9830591536 Enrollment ID: I20210716000820 |
Provider Name | Rafid Asfar |
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Provider Type | Practitioner - Rheumatology |
Provider Identifiers | NPI Number: 1639468747 PECOS PAC ID: 2961626486 Enrollment ID: I20211103001270 |
Provider Name | Venus Nguyen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053705087 PECOS PAC ID: 0941577001 Enrollment ID: I20220712003771 |
Provider Name | Michael E Schwartz |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1700847514 PECOS PAC ID: 3577620467 Enrollment ID: I20221214002611 |
Provider Name | Steven J Hernandez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013658525 PECOS PAC ID: 7113397522 Enrollment ID: I20221229001537 |
Provider Name | Benjamin Reisin |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1891952180 PECOS PAC ID: 3577924406 Enrollment ID: I20240131001429 |
Provider Name | Javier Lopez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770340515 PECOS PAC ID: 0749626604 Enrollment ID: I20240313003551 |
Provider Name | Amy Bullock |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1871997692 PECOS PAC ID: 3173054525 Enrollment ID: I20241009002131 |
Provider Name | Ashley Codding |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1609390657 PECOS PAC ID: 6901338086 Enrollment ID: I20241014003719 |
Imperial County Physicians Medical Group Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1503 N Imperial Ave Ste 105a, El Centro, CA 92243 Phone: 760-290-4297 | |
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 | |
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 | |