Healthcare Provider Details

I. General information

NPI: 1144917741
Provider Name (Legal Business Name): RAMBEL VEIN CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 04/24/2023
Certification Date: 04/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 G ST
BRAWLEY CA
92227-2544
US

IV. Provider business mailing address

1671 W MAIN ST STE B
EL CENTRO CA
92243-5420
US

V. Phone/Fax

Practice location:
  • Phone: 760-592-7760
  • Fax: 760-592-7765
Mailing address:
  • Phone: 760-592-7760
  • Fax: 760-592-7765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN F GUERRERO
Title or Position: CFO
Credential: FNP
Phone: 760-975-5305