Organization
IMPERIAL VALLEY PODIATRY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYRIL M GOSTICH DPM (PRESIDENT)
(760) 337-2800
Entity
Organization
Contact information
Practice address
1503 N IMPERIAL AVE, SUITE 105, EL CENTRO, CA 92243-6301
(760) 337-2800
(760) 337-9099
Mailing address
IMPERIAL VALLEY PODIATRY ASSOCIATES INC, P.O.BOX 650, EL CENTRO, CA 92244-0650
(760) 337-2800
(760) 337-9099
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3744
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GRE001481
—
CA
Enumeration date
07/18/2007
Last updated
11/17/2009
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