| Imperial Beach Health Center | |
|
949 Palm Avenue Imperial Beach CA 91932-1503 | |
| (619) 429-3733 | |
| (619) 429-6457 |
| Full Name | Imperial Beach Health Center |
|---|---|
| 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 Health Center Po Box 459 Imperial Beach CA 91933-0459 Ph: (619) 429-3733 | Imperial Beach Health Center 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 | James F Brown |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1073513610 PECOS PAC ID: 0143122473 Enrollment ID: I20040126000612 |
| Provider Name | Sretenka Dokich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154409035 PECOS PAC ID: 2769463892 Enrollment ID: I20040525001752 |
| Provider Name | Randall A Roark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447312178 PECOS PAC ID: 8820192842 Enrollment ID: I20070402000252 |
| Provider Name | Mary Moya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093844417 PECOS PAC ID: 4688774953 Enrollment ID: I20070716000509 |
| Provider Name | Daniel William Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245311216 PECOS PAC ID: 0446386551 Enrollment ID: I20100329000319 |
| Provider Name | Dana A Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780609990 PECOS PAC ID: 3678604089 Enrollment ID: I20100629000640 |
| 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 | Fabiola Del Aguila |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720283211 PECOS PAC ID: 9739329020 Enrollment ID: I20130710000266 |
| Provider Name | Terry E Carrilio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871994350 PECOS PAC ID: 2860715919 Enrollment ID: I20141223000247 |
| 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 | Bedeania R Zurek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942375811 PECOS PAC ID: 3072880343 Enrollment ID: I20170517002525 |
| Provider Name | Heather A Calzada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356841506 PECOS PAC ID: 3274895255 Enrollment ID: I20180403002065 |
| Provider Name | Obel Macias Borrajero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093280588 PECOS PAC ID: 9032455225 Enrollment ID: I20190109000686 |
| 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 | Arthur Roehr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851946016 PECOS PAC ID: 0840628319 Enrollment ID: I20200316001573 |
| Provider Name | Chinyere E Opara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083221683 PECOS PAC ID: 5092110890 Enrollment ID: I20210817001734 |
| Provider Name | Lauren S Debski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144874694 PECOS PAC ID: 9133520067 Enrollment ID: I20211216001810 |
| Provider Name | Samantha K Bodiford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730684200 PECOS PAC ID: 4486045291 Enrollment ID: I20220104002558 |
| Provider Name | Claudia Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770055543 PECOS PAC ID: 6204228836 Enrollment ID: I20220111002541 |
| 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 | Alaysa L Thygersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760107767 PECOS PAC ID: 8628447042 Enrollment ID: I20221207000954 |
| Provider Name | Katilynn Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174232748 PECOS PAC ID: 2062882848 Enrollment ID: I20230112001802 |
| Provider Name | Elizabeth L Browning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821431057 PECOS PAC ID: 7618293481 Enrollment ID: I20230221002017 |
| 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 |
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 | |
South Bay Behavioral Health Center 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 | |
South Bay Family Counseling Center 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 Health Center 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 |