IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP APC (NPI# 1275581894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275581894 |
| Entity Type | Organization |
| Organization Name | IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP APC |
| Practice Address |
516 West Aten Road Suite 2 Imperial CA 92251 |
| Practice Telephone | 7603557730 |
| Practice Fax Number | 7603557731 |
| Mailing Telephone | 7603557730 |
| Mailing Fax Number | 7603557731 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-10-29 |
| Authorized Official Name | VACHASPATHI PALAKODETI (PRESIDENT) |
| Authorized Official Telephone | 7603558300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0066312 | 05 | |
| CA | GR0066315 | 05 | |
| CA | GR0066313 | 05 | |
| CA | GR0066318 | 05 | |
| CA | GR0066314 | 05 | |
| CA | RAILROAD GROUP # | CC6635 | 01 |
| CA | GR0066310 | 05 | |
| CA | GR0066316 | 05 |
| Street Address |
516 WEST ATEN ROAD SUITE 2 |
| City | IMPERIAL |
| State | CA |
| Zip Code | 92251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750348033 | Imperial Valley Family Care Medical Group | Clinical Medical Laboratory | 516 West Aten Road, Suite 3, Imperial, CA 92251 | 2006-04-28 |
| 1922324326 | Stephanie Michelle Brammer | Physician Assistant | 516 West Aten Road, Suite 1, Imperial, CA 92251 | 2010-04-12 |
| 1649224387 | Vachaspathi Palakodeti | Internal Medicine | 516 West Aten Road, Suite 1, Imperial, CA 92251 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134656317 | Fronteras Interpreting | Interpreter | 284 W La Paz Drive, Imperial, CA 92251 | 2017-05-18 |
| 1639613128 | Surgery Centers of Imperial Valley Inc | Clinic/Center | 2402 Business Parkway, Suite 101, Imperial, CA 92251 | 2016-12-19 |
| 1508010315 | Bethzyra Guevara | Rehabilitation Counselor | 624 Ruby Street, Imperial, CA 92251 | 2008-11-06 |
| 1396929345 | Byron Justus | Dentist | 2387 Us Highwy 86, Imperial, CA 92251 | 2007-12-27 |
| 1154503894 | Gary G Cummings | Dentist | 2302 Brown Rd., Centinela State Prison, Imperial, CA 92251 | 2007-12-05 |
| 1396925160 | Dave Sat Khatri | Internal Medicine | 2302 Brown Road, Centinela State Prison, Imperial, CA 92251 | 2007-11-09 |
| 1144420928 | Freddy Carreno | Nurse Practitioner | 2302 Brown Rd, Imperial, CA 92251 | 2007-07-20 |
| 1336289818 | Herbert Ray Bumgart Jr. | Rehabilitation Counselor | 1295 State St Suite 106, El Centro, CA 92251 | 2007-02-07 |
| 1578668976 | Volunteers of America Southwest California | Skilled Nursing Facility | 100 E. Second Street, Imperial, CA 92251 | 2006-09-13 |
| 1598780736 | Bernardo Ng | Psychiatry & Neurology | 2417 Marshall Ave, Ste 1, Imperial, CA 92251 | 2006-07-12 |
| Find all providers in zip 92251 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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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.