NPIMap

Organization Active NPI

Imperial County Pediatric Associates, Inc.

  • Exclusive Provider Organization
  • El Centro, CA
National Provider Identifier
1164319463
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
IMPERIAL COUNTY PEDIATRIC ASSOCIATES, INC.
Practice address
702 Wake Ave
El Centro, CA 92243-7502
Phone
(760) 352-7216
NPI assigned
Jun 19, 2025
Last updated
Apr 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Lan Nhu Bich Phan
Title
Administrator
Phone
(626) 656-2370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X NU Primary

Addresses

Primary practice location

702 Wake Ave
El Centro, CA 92243-7502

Mailing address

6 Veranda
Newport Coast, CA 92657-1632
Phone (818) 399-8996

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1164319463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 VERANDA",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926571632",
            "telephone_number": "818-399-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 WAKE AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922437502",
            "telephone_number": "760-352-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL COUNTY PEDIATRIC ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "LAN",
        "authorized_official_middle_name": "NHU BICH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-656-2370",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.