Clinica Medica del Valle, Inc.

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

A66595 Issued in CA

Legal business name

CLINICA MEDICA DEL VALLE, INC.

Practice address

52-565 Harrison Street
Suite 104
Coachella, CA 92236-1534

Phone

(760) 398-0606

Fax

(760) 398-5507

NPI assigned

Dec 24, 2008

Last updated

Dec 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Juan M Acosta, MDNPI 1467423772

Title

President

Phone

(760) 398-0606

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Juan M. Acosta, MD

  • Pediatric Surgery Physician
  • Phoenix, AZ
  • NPI 1467423772

  CA

  Medicare reassignment NPD Authorized official
• Mitchell David Claire, P.A.

  • Physician Assistant
  • Coachella, CA
  • NPI 1881611317
  NPD (past)
• Job Portillo Lopez, FNP

  • Family Nurse Practitioner
  • Indio, CA
  • NPI 1871565796
  NPD (past)

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

{
    "created_epoch": "1230076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230076800000",
    "number": "1790921641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52-565 HARRISON STREET",
            "address_2": "SUITE 104",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361534",
            "telephone_number": "760-398-0606",
            "fax_number": "760-398-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52-565 HARRISON STREET",
            "address_2": "SUITE 104",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361534",
            "telephone_number": "760-398-0606",
            "fax_number": "760-398-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA DEL VALLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-24",
        "last_updated": "2008-12-24",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-398-0606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "A66595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Cid, LVN
• Cindy Tran, DDS, Inc. (SunShine Dental Group)
• CJ Professional Corporation (Coachella Joint Pain Center)
• Mitchell David Claire, P.A.
• Clinica Coachella, Inc
• Clinicas de Salud del Pueblo, Inc (Coachella Health Clinic)
• Coachella Kidney Institute, LLC
• Coachella Valley Parents
• Coachella Valley Rehabilitation
• Janelle Colangelo, PA-C

• Pediatric Surgery Physician in Coachella, CA
• Providers in Coachella, CA by specialty
• Pediatric Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.