1427220862 NPI number — OMNI FAMILY HEALTH

Table of content: (NPI 1427220862)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427220862 NPI number — OMNI FAMILY HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OMNI FAMILY HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NATIONAL HEALTH SERVICES, INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427220862
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4900 CALIFORNIA AVE
Provider Second Line Business Mailing Address:
400B
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93309-7081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-459-1900
Provider Business Mailing Address Fax Number:
661-459-1944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 JAMES STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHAFTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93263-2790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-459-1800
Provider Business Practice Location Address Fax Number:
661-459-1821
Provider Enumeration Date:
03/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CASTILLON
Authorized Official First Name:
FRANCISCO
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
661-630-7050

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  120000524 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 291U00000X , with the licence number: CLP 320413 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: CLP320413 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HAP70805F . This is a "MEDI-CAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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