Anesthesia Medical Group of Imperial Valley, Inc.
Organization Active NPI Anesthesiology Physician · Brawley, CA
NPI 1487087136 · NPPES record last updated Jun 21, 2019
Key facts
- NPI
- 1487087136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- ANESTHESIA MEDICAL GROUP OF IMPERIAL VALLEY, INC.
- Practice address
- 207 W Legion Rd
Brawley, CA 92227-7780 - Phone
- (760) 351-3288
- NPI assigned
- Aug 16, 2013
- Organization subpart
- No
Authorized official
- Name
- Jaime Anthone Englea-Larra, DO
- Title
- Group President
- Phone
- (760) 351-3288
Practitioners 36
-
Paula Monica M Deomampo, DNAP
-
Joana Mina Amparo, CRNA
-
Louie Amparo, CRNA
-
Clinton E. Flentje, CRNA
-
Daniel Garcia Jr., CRNA
-
Kimberly Gerber, CRNA
-
Michael V Hall, CRNA
-
Joseph Daniel Ortega, C.R.N.A.
-
Nicole Daniell Rubio, CRNA
-
David Sternbaum, DNP, CRNA
-
Mulugeta Temesgen, CRNA
-
Sammy James Hassan, M.D.
-
Robert James Orgill, CRNA
-
Jeffrey Keith Burney, CRNA
-
Jacob Alidore Foret, CRNA
-
Melissa C Hicks, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140303001946 | CA | Part B Supplier - Clinic/Group Practice | 9335379775 |
Receives reassigned benefits from 33 practitioners Practice locations: Brawley, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Pain Medicine (Anesthesiology) Physician |
207LP2900X | |||
| Pain Medicine Physician |
208VP0000X | |||
| Interventional Pain Medicine Physician |
208VP0014X |
Addresses
Primary practice location
207 W Legion Rd
Brawley, CA 92227-7780
Mailing address
PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725
Other practice location 1
751 W Legion Rd Ste 103
Brawley, CA 92227-7754
Phone (760) 351-4100
Other practice location 2
195 W Legion Rd
Brawley, CA 92227-7714
Phone (760) 351-8669
Other practice location 3
2402 Imperial Business Park Dr Ste 101
Imperial, CA 92251-4004
Phone (760) 351-8669
Other providers in Brawley, CA
- Amber Alvarez
- Claudia Ambriz
- Louie Amparo
- Elissa Renee Anaya
- Andrew Martino Chiropractic Corporation
- Stephany Angulo
- Vicenta Cuntapay Anque
- Manuel Arnoldo Araiza Chavez
- Sergio Arturo Armenta
- David J Ayala
All providers in Brawley, CA · Anesthesiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.