Provider Demographics
NPI:1790701142
Name:COUNTY OF IMPERIAL
Entity Type:Organization
Organization Name:COUNTY OF IMPERIAL
Other - Org Name:IMPERIAL COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-482-4438
Mailing Address - Street 1:935 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2349
Mailing Address - Country:US
Mailing Address - Phone:760-482-4438
Mailing Address - Fax:760-352-7747
Practice Address - Street 1:935 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2349
Practice Address - Country:US
Practice Address - Phone:760-482-4438
Practice Address - Fax:760-352-7747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACH05095OtherCHDP - LEAD PROGRAM
CALAB70166FOtherLABORATORY MEDI-CAL #
CAZZT11820FOtherCHDP PROVIDER NUMBER