MEDICARE: MCCABE UNION ELEMENTARY SCHOOL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1043912090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCCABE UNION ELEMENTARY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	701 W MCCABE RD
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-9507
Country	:	US
Telephone Number	:	760-335-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 W MCCABE RD
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-9507
Country	:	US
Telephone Number	:	760-335-5200
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SUPERINTENDENT
Name	:	MR. LUCIO PADILLA JR.
Credential	:
Telephone Number	:	760-335-5207

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/21/2023

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