Organization
CADE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA JANNETH CARDENAS (ADMINISTRATOR)
(239) 234-4377
Entity
Organization
Contact information
Practice address
120A ROCKWOOD AVE, PMB 43373, CALEXICO, CA 92231-4700
(760) 701-2440
Mailing address
120- A ROCKWOOD AVENUE, PMB 43373, CALEXICO, CA 92231
(760) 701-2440
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
3213567
ZZ
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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