Healthcare Provider Details

I. General information

NPI: 1285578518
Provider Name (Legal Business Name): CLINICAS DE SALUD DEL PUEBLO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N IMPERIAL AVE STE 103
IMPERIAL CA
92251-1399
US

IV. Provider business mailing address

852 E DANENBERG DR
EL CENTRO CA
92243-8517
US

V. Phone/Fax

Practice location:
  • Phone: 760-412-4414
  • Fax: 760-879-0038
Mailing address:
  • Phone: 760-344-9951
  • Fax: 760-344-1629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARLENE RIZO
Title or Position: CFO
Credential:
Phone: 760-344-9951