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Organization
IMPERIAL COUNTY LOCAL HEALTH AUTHORITY
Active
Organization
IMPERIAL COUNTY LOCAL HEALTH AUTHORITY
Active
Other names
Community Health Plan of Imperial Valley
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SOUTHWORTH (CFO)
(760) 970-5034
Entity
Organization
Contact information
Practice address
512 W ATEN RD, IMPERIAL, CA 92251-9718
(760) 970-5034
Mailing address
512 W ATEN RD, IMPERIAL, CA 92251-9718
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
NULL
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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