Healthcare Provider Details

I. General information

NPI: 1578611901
Provider Name (Legal Business Name): CLINICAS DE SALUD DEL PUEBLO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W COLE BLVD
CALEXICO CA
92231-9722
US

IV. Provider business mailing address

223 W COLE RD
CALEXICO CA
92231-9722
US

V. Phone/Fax

Practice location:
  • Phone: 760-357-2020
  • Fax: 760-357-1056
Mailing address:
  • Phone: 760-357-2020
  • Fax: 760-357-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberA33293
License Number StateCA

VIII. Authorized Official

Name: MRS. YVONNE BELL
Title or Position: CEO
Credential:
Phone: 760-344-9951