Provider Demographics
NPI:1265610778
Name:IMPERIAL COUNTY PUBLIC HEALTH DEPARTMENT
Entity type:Organization
Organization Name:IMPERIAL COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HODGKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-482-4704
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:760-482-4705
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:760-482-4705
Practice Address - Fax:760-352-7747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty