1740799725 NPI number — TELEHEALTHDOCS MEDICAL CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740799725 NPI number — TELEHEALTHDOCS MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TELEHEALTHDOCS MEDICAL CORPORATION
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:
6
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:
1740799725
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2215 TRUXTUN AVE STE 100
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:
93301-3602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-840-9270
Provider Business Mailing Address Fax Number:
661-864-7848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E NORTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAFT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93268-3606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-840-9270
Provider Business Practice Location Address Fax Number:
661-864-7848
Provider Enumeration Date:
09/22/2017

Additional Information

Authorized Official

Authorized Official Last Name:
LOUEY
Authorized Official First Name:
QUON
Authorized Official Middle Name:
TED
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
661-840-9270

Provider Taxonomy Codes

  • Taxonomy code: 171W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com