Healthcare Provider Details
I. General information
NPI: 1326214156
Provider Name (Legal Business Name): CALIFORNIA HEALTHFIRST PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4909 CENTENNIAL PLAZA WAY
BAKERSFIELD CA
93312-2011
US
IV. Provider business mailing address
PO BOX 10968
SAN BERNARDINO CA
92423-0968
US
V. Phone/Fax
- Phone: 661-587-8110
- Fax: 661-587-8183
- Phone: 909-335-7171
- Fax: 909-335-7140
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
PERKO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 909-335-7171