| Organization Name: | MERVAT KELADA M.D. A MEDICAL CORP |
| NPI Number: | 1356524599 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MERVAT G. KELADA (ADMINISTRATOR) |
| Mailing Address: | 1001 Blair Ave Calexico |
| State: | CA US |
| Postal Code: | 922312308 |
| Phone Number: | 7605626633 |
| Fax Number: | 7607685037 |
| NPI Enumeration Date: | 12/11/2007 |
| NPI Last Update Date: | 03/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |