1346313889 NPI number — CLINICAS DE SALUD DEL PUEBLO, INC

Table of content: (NPI 1346313889)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346313889 NPI number — CLINICAS DE SALUD DEL PUEBLO, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICAS DE SALUD DEL PUEBLO, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
INNERCARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346313889
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
852 E DANENBERG DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL CENTRO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-344-9951
Provider Business Mailing Address Fax Number:
760-344-5840

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
852 E DANENBERG DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL CENTRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-344-9951
Provider Business Practice Location Address Fax Number:
760-344-5840
Provider Enumeration Date:
11/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BELL
Authorized Official First Name:
YVONNE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
760-344-9951

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1356424212 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1649269747 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1699859421 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1962599266 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1124115431 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1023188687 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1124109202 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1487741773 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1679654750 . This is a "NPPES" identifier . This identifiers is of the category "OTHER".