EL CAJON MEDICAL GROUP INC (NPI# 1265967491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265967491 |
| Entity Type | Organization |
| Organization Name | EL CAJON MEDICAL GROUP INC |
| Practice Address |
751 W Legion Rd Ste 300 Brawley CA 92227-7755 |
| Mailing Address |
Po Box 7096 Stockton CA 95267-0096 |
| Practice Telephone | 7603514848 |
| Practice Fax Number | 7603513839 |
| Mailing Telephone | 2099567725 |
| Mailing Fax Number | 2099567733 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2019-02-03 |
| Authorized Official Name | DR. MEHBOOB GHULAM (OWNER) |
| Authorized Official Telephone | 7603514848 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 207 W Legion Rd, Brawley, CA 922277780 | 7603513333 | |
| 528 G St, Brawley, CA 922272411 | 7603447976 |
| Street Address |
751 W LEGION RD STE 300 |
| City | BRAWLEY |
| State | CA |
| Zip Code | 92227-7755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013118801 | Joseph Kurt Bivens | Plastic Surgery | 751 W Legion Rd Ste 300, Brawley, CA 92227 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548755283 | Imperial Valleyrespite, Inc. | Behavioral Analyst | 630 S. Imperial Ave., Ste. 2, Brawley, CA 92227 | 2018-06-26 |
| 1013424704 | Denise Vizcarra | Behavior Technician | 630 S Brawley Ave Ste 2, Brawley, CA 92227 | 2018-01-04 |
| 1831465178 | Marylou Cayetano Thelmo | Obstetrics & Gynecology | 1166 K Street, Brawley, CA 92227 | 2012-03-30 |
| 1396046983 | Dominga Marquez De Vera | Pharmacist | 475 West Main Street, Vons Pharmacy, Brawley, CA 92227 | 2010-11-12 |
| 1033441795 | Marshall Ray Debruler | Physician Assistant | 207 W. Legion Rd, Brawley, CA 92227 | 2010-02-05 |
| 1073758280 | Brawley Physical Therapy | Clinic/Center | 529 E Street, Brawley, CA 92227 | 2008-12-03 |
| 1609058924 | Leticia Bustamante | Nurse Practitioner | 751 West Legion Road, Suite 102, Brawley, CA 92227 | 2007-11-28 |
| 1073701504 | Imperial County Behavioral Health Services | Clinic/Center | 385 D St Rm 30, Brawley, CA 92227 | 2007-10-10 |
| 1083771489 | Yong Tan | Family Medicine | 751 West Legion Road, Suite 102, Brawley, CA 92227 | 2007-01-03 |
| 1174619738 | Donald M Ehman | Specialist | 197 W Legion Rd # 300, Brawley, CA 92227 | 2006-10-04 |
| Find all providers in zip 92227 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619237427 | Osagie Bello Md Inc. | Internal Medicine | 205 W Legion Rd Ste 1, Brawley, CA 92227-7780 | 2012-05-25 |
| 1649286485 | Reynaldo B Santmaina Md | Internal Medicine | 195 W Legion Rd, Brawley, CA 92227-7714 | 2006-08-01 |
| 1447290168 | Michael Krutzik | Internal Medicine | 528 G St, Brawley, CA 92227-2411 | 2006-06-08 |
| 1598758625 | Nabil H. Abbassi | Internal Medicine | 1166 K St, Brawley, CA 92227-2737 | 2005-08-24 |
| 1316446644 | Imperial Valley Hospitalist Inc | Internal Medicine | 207 W Legion Rd, Brawley, CA 92227-7780 | 2018-02-01 |
| 1104116805 | Brawley Occupational Medicine | Internal Medicine | 529 E St, Brawley, CA 92227-1930 | 2011-04-14 |
| 1215248273 | Mehboob Ghulam | Internal Medicine | 751 W Legion Rd, Suite 300, Brawley, CA 92227-7755 | 2010-06-24 |
| 1578897690 | Hospitalist Medicine Physicians of Imperial County, Inc.. | Internal Medicine | 207 W Legion Rd, Brawley, CA 92227-7780 | 2009-09-22 |
| 1083898902 | Sunny R Richley Md Corporation | Internal Medicine | 751 W Legion Rd Ste 103, Brawley, CA 92227 | 2007-12-27 |
| 1205034733 | Oscar A Lopez | Internal Medicine | 751 W Legion Rd Ste 103, Brawley, CA 92227-7754 | 2007-07-05 |
| Find all providers in BRAWLEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.