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Organization
ICPMD
Active
Organization
ICPMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERVAT KELADA MD (CEO)
(760) 562-6633
Entity
Organization
Contact information
Practice address
207 E BARIONI BLVD STE A, IMPERIAL, CA 92251-1620
(760) 355-2999
(760) 768-5037
Mailing address
1001 BLAIR AVE, CALEXICO, CA 92231-2308
(760) 562-6633
(760) 768-5037
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/20/2025
Last updated
07/17/2025
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