Healthcare Provider Details

I. General information

NPI: 1841836459
Provider Name (Legal Business Name): BIENESTAR COMMUNITY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 05/03/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 34TH ST
BAKERSFIELD CA
93301-2208
US

IV. Provider business mailing address

620 34TH ST
BAKERSFIELD CA
93301-2208
US

V. Phone/Fax

Practice location:
  • Phone: 661-247-1010
  • Fax: 661-404-4715
Mailing address:
  • Phone: 661-247-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIGRAN ARUTYUNYAN
Title or Position: CEO
Credential:
Phone: 661-247-1010