Healthcare Provider Details

I. General information

NPI: 1538019880
Provider Name (Legal Business Name): IMPERIAL VALLEY PODIATRY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E BIRCH ST STE 2
CALEXICO CA
92231-5925
US

IV. Provider business mailing address

801 E BIRCH ST STE 2
CALEXICO CA
92231-5925
US

V. Phone/Fax

Practice location:
  • Phone: 760-890-0113
  • Fax: 442-252-7018
Mailing address:
  • Phone: 760-890-0113
  • Fax: 442-252-7018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL A IRONS
Title or Position: CEO
Credential:
Phone: 951-315-0378