Provider Demographics
NPI:1518453026
Name:EMCS HEALTHCARE OF IMPERIAL COUNTY A JD WEILBACKER DO COMPANY
Entity Type:Organization
Organization Name:EMCS HEALTHCARE OF IMPERIAL COUNTY A JD WEILBACKER DO COMPANY
Other - Org Name:EMCS HEALTHCARE EMERGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEILBACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-566-0205
Mailing Address - Street 1:2451 ROCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-4404
Mailing Address - Country:US
Mailing Address - Phone:419-566-0205
Mailing Address - Fax:
Practice Address - Street 1:2451 ROCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231
Practice Address - Country:US
Practice Address - Phone:419-566-0205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty