Healthcare Provider Details

I. General information

NPI: 1972420073
Provider Name (Legal Business Name): AVERON PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
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: 760-675-1125
  • Fax: 760-682-3252
Mailing address:
  • Phone: 760-675-1125
  • Fax: 760-682-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANGEL COLLADO
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 760-675-1125