Healthcare Provider Details

I. General information

NPI: 1316431935
Provider Name (Legal Business Name): JUAN CARLOS HUERTA GALINDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 34TH ST STE 100&200
BAKERSFIELD CA
93301-2305
US

IV. Provider business mailing address

625 34TH ST STE 100&200
BAKERSFIELD CA
93301-2305
US

V. Phone/Fax

Practice location:
  • Phone: 833-678-2781
  • Fax: 661-368-0618
Mailing address:
  • Phone: 833-678-2781
  • Fax: 661-368-0618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number036159699
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA188292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: