Healthcare Provider Details
I. General information
NPI: 1801910633
Provider Name (Legal Business Name): CLINICA SIERRA VISTA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2007
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1305 BEAR MOUNTAIN BLVD STE B
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: 661-732-3064
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
OLGA
MEAVE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 661-635-3050