Imperial Valley Endocrine Medical Corporation

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A70812 Issued in CA

Legal business name

IMPERIAL VALLEY ENDOCRINE MEDICAL CORPORATION

Practice address

528 G St
Brawley, CA 92227-2411

Phone

(760) 344-6355

Fax

(760) 344-6921

NPI assigned

Aug 1, 2007

Organization subpart

No

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

Authorized official

Name

Ramona A Krutzik, MDNPI 1881779296

Title

Ceo

Phone

(760) 344-1881

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ramona Alicia Krutzik, MD

  • Internal Medicine Physician
  • Sun City, AZ
  • NPI 1881779296

  CA, Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1265623524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 G ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272411",
            "telephone_number": "760-344-6355",
            "fax_number": "760-344-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 G ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272411",
            "telephone_number": "760-344-6355",
            "fax_number": "760-344-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL VALLEY ENDOCRINE MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "KRUTZIK",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-344-1881",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A70812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A708120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imperial County Behavioral Health Services
• Imperial County Behavioral Health Services
• Imperial Endovascular PC
• Imperial Heights Healthcare & Wellness Centre LLC
• Imperial Manor Skilled Nursing Inc
• Imperial Valley Family Care Medical Group, Apc
• Imperial Valley Healthcare District
• Imperial Valley Healthcare District
• Imperial Valley Healthcare District
• Imperial Valley Healthcare District

• Endocrinology, Diabetes & Metabolism Physician in Brawley, CA
• Providers in Brawley, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.