| Innercare - Brawley | |
|
900 Main St Brawley CA 92227-2630 | |
| (760) 344-6471 | |
| (760) 344-8410 |
| Full Name | Innercare - Brawley |
|---|---|
| Speciality | Clinic/Center |
| Location | 900 Main St, Brawley, California |
| Authorized Official Name and Position | Yvonne Bell (CEO) |
| Authorized Official Contact | 7603449951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innercare - Brawley 852 E Danenberg Dr El Centro CA 92243 Ph: (760) 344-9951 | Innercare - Brawley 900 Main St Brawley CA 92227-2630 Ph: (760) 344-6471 |
| NPI Number | 1649269747 |
|---|---|
| Provider Enumeration Date | 10/20/2005 |
| Last Update Date | 02/18/2022 |
| Medicare PECOS PAC ID | 5496657082 |
|---|---|
| Medicare Enrollment ID | O20040123000584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649269747 | NPI | - | NPPES |
| EAP03830F | Medicaid | CA | |
| FHC03830F | Medicaid | CA | |
| HAP03830F | Medicaid | CA | |
| BCP03830F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000030 (California) | Primary |
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