Organization
IMPERIAL VALLEY MULTI-SPECIALTY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIVARAMAN K GOUNDER M.D. (SECRETARY)
(908) 361-0185
Entity
Organization
Contact information
Practice address
2061 ROSS AVE, SUITE A, EL CENTRO, CA 92243-3687
(908) 361-0185
Mailing address
2061 ROSS AVE, SUITE A, EL CENTRO, CA 92243-3687
(908) 361-0185
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A113016
CA
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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