Healthcare Provider Details

I. General information

NPI: 1710926472
Provider Name (Legal Business Name): UBERTO T MUZZARELLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 EAST BIRCH STREET CALEXICO HELATH CENTER
CALEXICO CA
92231
US

IV. Provider business mailing address

605 WEST H STREET ADVANCED MEDICAL BILLING SUITE 110
BRAWLEY CA
92227
US

V. Phone/Fax

Practice location:
  • Phone: 760-768-6262
  • Fax: 760-768-6292
Mailing address:
  • Phone: 760-344-7976
  • Fax: 760-344-7106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG16266
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: