Chuckawala Vallwy State Prison
Organization Active NPI Prison Health Clinic/Center · Blythe, CA
NPI 1356701494 · NPPES record last updated Mar 2, 2016
Key facts
- NPI
- 1356701494
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prison Health Clinic/Center 261QP2400X
- License
- 63848 (CA)
- Legal business name
- CHUCKAWALA VALLWY STATE PRISON
- Practice address
- 19025 Wileys Well Rd
Blythe, CA 92225-2287 - Phone
- (760) 922-5300
- NPI assigned
- Mar 2, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael Lee, M.D.
- Title
- Cme
- Phone
- (760) 922-5300
Practitioners 12
-
Romeo Felito Ang Jr., M.D.
-
Mitin Bhatia, DDS
-
Jennifer E. Jones, D.D.S.
-
Don H. Lee, D.D.S.
-
Tai Liao, D.D.S.
-
Philip Maldonado, DMD
-
Joseph McDonnell Jr., PSYD
-
Tony Tuan Nguyen, PHARM.D
-
Rosalinda Rey Perez, RPH
National Provider Directory
Locations
19025 Wileys Well Rd
Blythe, CA 92225
Phone (760) 922-5300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prison Health Clinic/Center | 261QP2400X | 63848 | CA | Yes |
Addresses
Primary practice location
19025 Wileys Well Rd
Blythe, CA 92225-2287
Mailing address
19025 Wileys Well Rd
Blythe, CA 92225-2287
Phone (760) 922-5300
Other providers in Blythe, CA
- Jaime Rivera Ceron Jr.
- Montay Chatmon
- Nancy Chun-Ching Chen
- Maimoona Chinwala
- Leon Peter Y Chua
- Eric Joseph Clark
- Erica Danielle Clark
- Clear Vision Treatment Centers Inc.
- Clinicas de Salud del Pueblo, Inc
- Aurora Angela Colangeli
All providers in Blythe, CA · Prison Health Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.