MEDICARE: PALO VERDE HEALTH CARE 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	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740667179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALO VERDE HEALTH CARE DISTRICT

Provider Business Mailing Address
First Line	:	250 N 1ST ST
Second Line	:
City	:	BLYTHE
State	:	CA
Zip	:	92225-1702
Country	:	US
Telephone Number	:	760-922-4115
Fax Number	:	760-921-5263

Provider Business Practice Location Address
First Line	:	291 N SECOND STREET
Second Line	:
City	:	BLYTHE
State	:	CA
Zip	:	92225-1777
Country	:	US
Telephone Number	:	760-922-4115
Fax Number	:	760-921-5263

Authorized Official
Title or Position	:	EXECUTIVE LEADERSHIP ASSISTANT
Name	:	MRS. REGINA VELOZ
Credential	:
Telephone Number	:	760-921-5150

Provider Enumeration Date	:	05/06/2015
Last Update Date	:	02/19/2025

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Directions to “PALO VERDE HEALTH CARE DISTRICT ” Practice Location

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