| Imperial Beach Community Clinic | |
|
949 Palm Avenue Imperial Beach CA 91932-1503 | |
| (619) 429-3733 | |
| (619) 429-6457 |
| Full Name | Imperial Beach Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 949 Palm Avenue, Imperial Beach, California |
| Authorized Official Name and Position | Constance Kirk (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6194295387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imperial Beach Community Clinic Po Box 459 Imperial Beach CA 91933-0459 Ph: (619) 429-3733 | Imperial Beach Community Clinic 949 Palm Avenue Imperial Beach CA 91932-1503 Ph: (619) 429-3733 |
| NPI Number | 1790718351 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 05/27/2010 |
| Medicare PECOS PAC ID | 6709867880 |
|---|---|
| Medicare Enrollment ID | O20040525001394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790718351 | NPI | - | NPPES |
| 40 | Other | CA | COUNTY MEDICAL SERVICES |
| HAP11826F | Other | CA | FAMILY PACT |
| EAP11826F | Other | CA | EAPC |
| FHC11826F | Medicaid | CA | |
| BCP11826F | Other | CA | CDP |
| FHC11826F | Other | CA | MEDI CAL |
| 05D0683042 | Other | LABORATORY CLIA NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Steven F Ritter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356556021 PECOS PAC ID: 2668481607 Enrollment ID: I20060419000389 |
| Provider Name | Daniel William Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245311216 PECOS PAC ID: 0446386551 Enrollment ID: I20100329000319 |
| Provider Name | Faith P Chisum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346432069 PECOS PAC ID: 6002949831 Enrollment ID: I20100730000751 |
| Provider Name | Courtney A Summers-day |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124288873 PECOS PAC ID: 3476707415 Enrollment ID: I20130129000263 |
| Provider Name | Carolyn M Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609101997 PECOS PAC ID: 0042358509 Enrollment ID: I20150807015578 |
| Provider Name | Francesca A Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649720756 PECOS PAC ID: 0244511657 Enrollment ID: I20161223000256 |
| Provider Name | Priscilla J Campos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508217399 PECOS PAC ID: 6507108560 Enrollment ID: I20190424000279 |
| Provider Name | Maria Elena Almirante |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1700230364 PECOS PAC ID: 5496087785 Enrollment ID: I20191106002198 |
| Provider Name | Katherine L Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831557024 PECOS PAC ID: 7214232735 Enrollment ID: I20200715002598 |
| Provider Name | Chinyere E Opara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083221683 PECOS PAC ID: 5092110890 Enrollment ID: I20210817001734 |
| Provider Name | Samantha K Bodiford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730684200 PECOS PAC ID: 4486045291 Enrollment ID: I20220104002558 |
| Provider Name | Lesley Lara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184112682 PECOS PAC ID: 7810382983 Enrollment ID: I20220328002244 |
| Provider Name | Stefany I O'connell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386378479 PECOS PAC ID: 0547637647 Enrollment ID: I20221118002635 |
| Provider Name | Anish Dhamija |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063946275 PECOS PAC ID: 4082060926 Enrollment ID: I20231027002633 |
| Provider Name | Benjamin A Van Pratt Levin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619438330 PECOS PAC ID: 9830570803 Enrollment ID: I20231109002465 |
| Provider Name | Marianna Y Gonzalez Chavez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124532940 PECOS PAC ID: 6103264452 Enrollment ID: I20240404003588 |
| Provider Name | Ryan E Pascua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972064269 PECOS PAC ID: 3476995895 Enrollment ID: I20241220003464 |
| Provider Name | Emily A Walsh |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1134769490 PECOS PAC ID: 3476080912 Enrollment ID: I20241223002744 |
| Provider Name | Renuka Rajiv |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821819301 PECOS PAC ID: 6204366362 Enrollment ID: I20250205002016 |
| Provider Name | William K Chin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821062308 PECOS PAC ID: 1254581721 Enrollment ID: I20250205002216 |
| Provider Name | Abigail F Luna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366299315 PECOS PAC ID: 4688104110 Enrollment ID: I20250212002501 |
| Provider Name | Gisela Arellano-banoni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790098341 PECOS PAC ID: 8628292661 Enrollment ID: I20250227003244 |
Vn Healthy Living Medical Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 707 Palm Ave, Imperial Beach, CA 91932 Phone: 619-429-7700 | |
L'abbe And Berkenfield Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Palm Ave, Suite 108a, Imperial Beach, CA 91932 Phone: 619-575-7170 Fax: 619-575-7192 | |
Sage Traditions Acupuncture Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Palm Ave Ste 2, Imperial Beach, CA 91932 Phone: 619-392-0937 Fax: 619-565-2288 | |
Family Health Centers Of San Diego, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 740 10th St, Imperial Beach, CA 91932 Phone: 619-906-5323 Fax: 619-269-0589 | |
Family Health Centers Of San Diego, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 742 10th St, Imperial Beach, CA 91932 Phone: 619-906-5322 Fax: 619-269-0484 | |
Imperial Beach Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 949 Palm Avenue, Imperial Beach, CA 91932 Phone: 619-429-3733 Fax: 619-429-6457 | |
Cochrane Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 667 Palm Ave, Imperial Beach, CA 91932 Phone: 619-575-8887 Fax: 619-575-1374 |