Healthcare Provider Details

I. General information

NPI: 1609642099
Provider Name (Legal Business Name): MANUEL HAZAEL BARRIGA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 PEPPER DR STE C
EL CENTRO CA
92243-4166
US

IV. Provider business mailing address

125 S 5TH ST
BRAWLEY CA
92227-2408
US

V. Phone/Fax

Practice location:
  • Phone: 760-312-5900
  • Fax: 866-493-3117
Mailing address:
  • Phone: 760-344-8100
  • Fax: 866-493-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95024078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: