Organization · Type 2 NPI
Icpmd
General Practice Physician · Imperial, CA
NPI number
1609763721
Active
Practice location
207 E Barioni Blvd Ste A
Imperial, CA 92251-1620
Fax (760) 768-5037
Mailing address
1001 Blair Ave
Calexico, CA 92231-2308
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Another provider at this address
Other general practice physician providers in Imperial
About NPI 1609763721
Icpmd's National Provider Identifier is 1609763721, issued on Jun 20, 2025. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Imperial, CA. The record was last updated on Jul 17, 2025.