MEDICARE: MATHIAS EL TRIBE CHARITABLE TRUST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251V00000X	Voluntary or Charitable Agency
2	253Z00000X	In Home Supportive Care Agency
3	251E00000X	Home Health Agency
4	347C00000X	Private Vehicle
5	261QF0050X	Non-Surgical Family Planning Clinic/Center
6	261QR1300X	Rural Health Clinic/Center
7	332800000X	Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

General Provider Information

NPI Number	:	1215786538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATHIAS EL TRIBE CHARITABLE TRUST

Provider Business Mailing Address
First Line	:	MATHIAS EL TRIBE
Second Line	:	4305 SUN DEVILS AVENUE
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313
Country	:	US
Telephone Number	:	818-477-7244
Fax Number	:

Provider Business Practice Location Address
First Line	:	4305 SUN DEVILS AVENUE
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313
Country	:	US
Telephone Number	:	818-477-7244
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MATHIAS EL/ CTH
Name	:	MATHEW-ALLEN MCCASTER
Credential	:	NP
Telephone Number	:	818-477-7244

Provider Enumeration Date	:	05/17/2024
Last Update Date	:	05/22/2024

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