Healthcare Provider Details

I. General information

NPI: 1043248719
Provider Name (Legal Business Name): JOHN MARSHALL STRONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1699 N IMPERIAL AVE
EL CENTRO CA
92243-1320
US

IV. Provider business mailing address

1699 N IMPERIAL AVE
EL CENTRO CA
92243-1320
US

V. Phone/Fax

Practice location:
  • Phone: 760-352-2551
  • Fax: 888-631-5150
Mailing address:
  • Phone: 760-352-2551
  • Fax: 888-631-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG85954
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberG85954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: