Chuckawala Vallwy State Prison
NPI #1356701494 in Blythe, California
Provider Information
- NPI Number
- 1356701494
- Entity Type
- Organization
- Organization Name
- Chuckawala Vallwy State Prison
- Primary Specialty
- Clinic/Center - Prison Health
- Enumeration Date
- Mar 2, 2016
- Last Updated
- Mar 2, 2016
Practice Location
- Address
- 19025 WILEYS WELL RD
- City
- Blythe
- State
- California
- ZIP Code
- 92225-2287
- Phone
- (760) 922-5300
Authorized Official
- Name
- DR. MICHAEL LEE, M.D.
- Title
- CME
- Phone
- (760) 922-5300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Prison Health — Prison Health |
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