Organization
IMPERIAL VALLEY WOMENS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN E GOCKE MD (PRESIDENT)
(760) 353-3331
Entity
Organization
Contact information
Practice address
495 E ORANGE AVE, EL CENTRO, CA 92243
(760) 353-3331
(760) 353-5085
Mailing address
495 E ORANGE AVE, EL CENTRO, CA 92243
(760) 353-3331
(760) 353-5085
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB72222F
—
CA
05
—
ZZZ79332Z
—
CA
Enumeration date
08/16/2006
Last updated
10/26/2009
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