1649381807 NPI number — CENTRAL CALIFORNIA HOSPITALISTS

Table of content: (NPI 1649381807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649381807 NPI number — CENTRAL CALIFORNIA HOSPITALISTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL CALIFORNIA HOSPITALISTS
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:
Provider Other Organization Name Type Code:
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:
1649381807
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 12798
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93389-2798
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-332-3355
Provider Business Mailing Address Fax Number:
661-332-3355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 GARCES HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELANO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-332-3355
Provider Business Practice Location Address Fax Number:
661-859-1209
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SRIVASTAVA
Authorized Official First Name:
SHAKTI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
661-332-3355

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: GR0103731 . This is a "MEDI-CAL-MERCY SW" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GR0103730 . This is a "MEDI-CAL-MERCY TRUXTUN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".