Provider Demographics
NPI:1619631363
Name:HOSPITAL VELMAR
Entity Type:Organization
Organization Name:HOSPITAL VELMAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:VELAZCO
Authorized Official - Last Name:ARIZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-173-4500
Mailing Address - Street 1:HOSPITAL VELMAR
Mailing Address - Street 2:9169 W STATE ST #2532
Mailing Address - City:GARDEN CITY
Mailing Address - State:ID
Mailing Address - Zip Code:83714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL VELMAR
Practice Address - Street 2:DE LAS ARENAS 151 PLAYA ENSENADA
Practice Address - City:ENSENADA
Practice Address - State:BC
Practice Address - Zip Code:22880
Practice Address - Country:MX
Practice Address - Phone:646-173-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
ISB040324GTAOtherSTATE