Organization
ANESTHESIA MEDICAL GROUP OF IMPERIAL VALLEY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME ANTHONE ENGLEA-LARRA DO (GROUP PRESIDENT)
(760) 351-3288
Entity
Organization
Contact information
Practice address
207 W LEGION RD, BRAWLEY, CA 92227-7780
(760) 351-3288
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
08/16/2013
Last updated
06/21/2019
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