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General NPI Number Information
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NPI Number | 1649269747
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Entity Type | Organization
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Legal Business Name | CLINICAS DE SALUD DEL PUEBLO, INC.
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 900 MAIN ST
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City | BRAWLEY
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State | CA
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Zip | 92227-2630
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Country | US
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Telephone | 760-344-6471
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Fax | 760-344-8410
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Provider Business Mailing Address
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Address Line | 852 E DANENBERG DR
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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 | 760-344-9951
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Fax | 760-344-5840
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Authorized Official
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Title or Position | CEO
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Name | MS. YVONNE BELL
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Credential |
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Telephone | 760-344-9951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 090000030
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License Number State | CA
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