| NAME |
IMPERIAL VALLEY CBOC |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
1115 SOUTH 4TH STREET |
| CITY |
EL CENTRO |
| ZIP |
92243-4741 |
| OFFICIAL VA NAME |
IMPERIAL VALLEY CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
EL CENTRO VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1366498313
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
664GA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1366498313
-
- CODING SYSTEM: VASTANUM
- ID: 664GA
-
- CODING SYSTEM: CLIA
- ID: 05D1104270
|
