Healthcare Provider Details

I. General information

NPI: 1205366382
Provider Name (Legal Business Name): ALAN C MCGEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 06/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY
BAKERSFIELD CA
93309-2656
US

IV. Provider business mailing address

5121 STOCKDALE HWY STE 200
BAKERSFIELD CA
93309-2664
US

V. Phone/Fax

Practice location:
  • Phone: 661-473-1500
  • Fax:
Mailing address:
  • Phone: 661-473-1500
  • Fax: 661-735-8559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA010600315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: