Healthcare Provider Details
I. General information
NPI: 1700910080
Provider Name (Legal Business Name): CLINICA SIERRA VISTA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/16/2007
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1305 BEAR MOUNTAIN BLVD
ARVIN CA
93203-1231
US
IV. Provider business mailing address
PO BOX 1559
BAKERSFIELD CA
93302-1559
US
V. Phone/Fax
- Phone: 661-854-3131
- Fax: 661-854-2689
- Phone: 661-635-3050
- Fax: 661-869-1503
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0050X |
| Taxonomy | Non-Surgical Family Planning Clinic/Center |
| License Number | 120000525 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
OLGA
MEAVE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 661-635-3050