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Contact Information

IMPERIAL VALLEY OPTOMTRIC CORPORATION
1113 IMPERIAL AVE. W.
STE 103
CALEXICO, CA92231
 Phone: 760-336-3003
 Fax: 888-210-5799
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for IMPERIAL VALLEY OPTOMTRIC CORPORATION

NPI Number 1508143827
LBN Legal business name IMPERIAL VALLEY OPTOMTRIC CORPORATION
Authorized official MAY TAM - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/15/2011
Last updated 11/15/2011 - About 15 years ago
Identifiers
CA Medicaid GSD005600
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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