Provider Type Icon

IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP NPI 1750348033


NPI Information

NPI: 1750348033
Provider Name: IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP

Other Name: IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP LABORATORY

Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization

CLIA Number: 05D0681409

Address:
516 WEST ATEN ROAD
SUITE 3
IMPERIAL, CA
ZIP 92251
Phone: (760) 355-2701
Get Directions

IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP is a clinical medical laboratory in Imperial, CA. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP NPI is 1750348033. The provider is registered as an organization entity type.
The provider Other Name Is Imperial Valley Family Care Medical Group Laboratory.

The provider's business location address is:

516 WEST ATEN ROAD
SUITE 3
IMPERIAL, CA
ZIP 92251
Phone: (760) 355-2701
Fax: (760) 355-8397

The provider's authorized official is Vachaspathi Palakodeti .
The authorized official title is President and has the following contact phone number (760) 355-7730.

The CLIA number assigned to this NPI record is 05D0681409 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 4/28/2006 and was last updated on 4/24/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical Laboratory05D0973957CALIFORNIANo
2291U00000XClinical Medical Laboratory05D0681409CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P00164275OTHERCALIFORNIARAIL ROAD PIN
2CC6635OTHERCALIFORNIARAILROAD GROUP #
3LAB81409FMEDICAIDCALIFORNIA
405D0681409MEDICARE PINCALIFORNIA
505D0973957MEDICARE PINCALIFORNIA
61275581894OTHERCALIFORNIAGROUP NPI
705D0681409OTHERCALIFORNIACLIA #
805D0681409MEDICARE OSCAR/CERTIFICATIONCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.