Organization
PALO VERDE USD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN JENSEN (SUPERINTENDENT)
(760) 922-4164
Entity
Organization
Contact information
Practice address
295 N 1ST ST, BLYTHE, CA 92225-1703
(760) 922-4164
Mailing address
3333 CONCOURS, ONTARIO, CA 91764-4875
(909) 944-7798
(909) 481-7410
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SS3367181
MEDI-CAL
CA
Enumeration date
01/15/2007
Last updated
08/22/2020
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