Healthcare Provider Details

I. General information

NPI: 1598643785
Provider Name (Legal Business Name): IMPERIAL VALLEY CARDIOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 4TH ST STE E
CALEXICO CA
92231-2714
US

IV. Provider business mailing address

200 E 4TH ST STE E
CALEXICO CA
92231-2714
US

V. Phone/Fax

Practice location:
  • Phone: 818-688-2566
  • Fax:
Mailing address:
  • Phone: 818-688-2566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN H FARBER
Title or Position: CEO/OWNER
Credential: MD
Phone: 818-688-2566