Provider Demographics
NPI:1578368478
Name:IMPERIAL VALLEY HEALTHCARE DISTRICT
Entity type:Organization
Organization Name:IMPERIAL VALLEY HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-351-3594
Mailing Address - Street 1:207 W LEGION RD
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-7780
Mailing Address - Country:US
Mailing Address - Phone:760-351-3341
Mailing Address - Fax:760-351-3155
Practice Address - Street 1:450 E BIRCH ST
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-2334
Practice Address - Country:US
Practice Address - Phone:760-768-6262
Practice Address - Fax:760-768-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health