Healthcare Provider Details

I. General information

NPI: 1962437723
Provider Name (Legal Business Name): SAN JOAQUIN COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 CHESTER AVE
BAKERSFIELD CA
93301-2006
US

IV. Provider business mailing address

2615 CHESTER AVE
BAKERSFIELD CA
93301-2006
US

V. Phone/Fax

Practice location:
  • Phone: 661-395-3000
  • Fax:
Mailing address:
  • Phone: 661-395-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number0688950001
License Number StateCA

VIII. Authorized Official

Name: MR. ROBERT BEEHLER
Title or Position: PRESIDENT-CEO
Credential:
Phone: 661-395-3000