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NPI Code Detail

MEDICARE: CLINICA SIERRA VISTA

MEDICARE: CLINICA SIERRA VISTA
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)120000198CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HAP11656GOTHERCASOFP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3BCP11656GOTHERCACDP

General Provider Information

NPI Number : 1659373017
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICA SIERRA VISTA
Provider Business Mailing Address
First Line : PO BOX 1559
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93302-1559
Country : US
Telephone Number : 661-635-3050
Fax Number : 661-732-3064
Provider Business Practice Location Address
First Line : 301 BRUNDAGE LN
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93304-3248
Country : US
Telephone Number : 661-323-6086
Fax Number : 661-324-6301
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DR. OLGA MEAVE
Credential : MD
Telephone Number : 661-635-3050
Provider Enumeration Date : 08/15/2005
Last Update Date : 04/17/2025

Similar Medicare Providers

1073647350 — CLINICA SIERRA VISTA
Practice Location Address:
301 BRUNDAGE LN
BAKERSFIELD, CA
93304-3248
Practice Phone: 661-323-6086
Practice Fax: 661-324-6301
1710006176 — MS. QUYEN H NGUYEN NP
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301 BRUNDAGE LN
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1689853673 — MRS. MICHELE ANN CROTTEAU CPNP-PC
Practice Location Address:
301 BRUNDAGE LN
BAKERSFIELD, CA
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Practice Fax: 661-324-6301
1609029255 — JAMES SCOTT JOHNSTON M.D.
Practice Location Address:
301 BRUNDAGE LN
BAKERSFIELD, CA
93304-3248
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Practice Fax: 661-324-6301
1982973582 — DR. MEL CLARK REQUIAS TAVEROS M.D.
Practice Location Address:
301 BRUNDAGE LN
BAKERSFIELD, CA
93304-3248
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1336544790 — CLINICA SIERRA VISTA
Practice Location Address:
301 BRUNDAGE LN
BAKERSFIELD, CA
93304-3248
Practice Phone: 661-635-3050
Practice Fax:

Directions to “CLINICA SIERRA VISTA ” Practice Location

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