# IMPERIAL VALLEY FAMILY CARE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376820159
- **Authorized official:** VACHASPATHI PALAKODETI M.D. (PRESIDENT)
- **Authorized official phone:** (760) 355-7730

## Contact information

- **Practice address:** 1520 SOUTH IMPERIAL AVENUE, EL CENTRO, CA 92243
- **Practice address phone:** (760) 592-4586
- **Practice address fax:** (760) 545-0252
- **Mailing address:** 516 WEST ATEN ROAD SUITE 2, IMPERIAL, CA 92251
- **Mailing address phone:** (760) 355-7730
- **Mailing address fax:** (760) 355-7731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2011
- **Last updated:** 11/08/2011