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General NPI Number Information
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NPI Number | 1336025162
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Entity Type | Organization
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Legal Business Name | COUNTY OF IMPERIAL
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 328 APPLESTILL ROAD
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City | EL CENTRO
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State | CA
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Zip | 92243
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Country | US
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Telephone | 442-265-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 940 W. MAIN STREET SUITE 208
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City | EL CENTRO
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State | CA
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Zip | 92243
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SHERIFF-CORONER-MARSHAL
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Name | FRED MIRAMONTES
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Credential |
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Telephone | 442-265-2005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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License Number State |
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