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General NPI Number Information
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NPI Number | 1316033459
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Entity Type | Organization
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Legal Business Name | THEODORE AFFUE M D INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2061 ROSS AVE STE A&B
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City | EL CENTRO
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State | CA
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Zip | 92243-3687
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Country | US
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Telephone | 760-353-8181
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Fax | 760-353-8282
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Provider Business Mailing Address
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Address Line | 2061 ROSS AVE STE A
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City | EL CENTRO
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State | CA
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Zip | 92243-3687
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Country | US
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Telephone | 760-353-8181
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Fax | 760-353-8282
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THEODORE AFFUE
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Credential |
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Telephone | 760-353-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G58320
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License Number State | CA
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