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General NPI Number Information
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NPI Number | 1598160707
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Entity Type | Organization
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Legal Business Name | CADE
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 120A ROCKWOOD AVE PMB 43373
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City | CALEXICO
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State | CA
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Zip | 92231-4700
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Country | US
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Telephone | 760-701-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 120- A ROCKWOOD AVENUE PMB 43373
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City | CALEXICO
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State | CA
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Zip | 92231
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Country | US
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Telephone | 760-701-2440
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VERONICA JANNETH CARDENAS
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Credential |
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Telephone | 239-234-4377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 3213567
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License Number State | ZZ
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