Healthcare Provider Details

I. General information

NPI: 1639613763
Provider Name (Legal Business Name): CASCADE HEALTH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 COMMERCIAL WAY STE. D
BAKERSFIELD CA
93309-0407
US

IV. Provider business mailing address

1400 EASTON DR STE. 106
BAKERSFIELD CA
93309-9412
US

V. Phone/Fax

Practice location:
  • Phone: 661-324-4100
  • Fax: 661-324-4600
Mailing address:
  • Phone: 661-324-4100
  • Fax: 661-324-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA49366
License Number StateCA

VIII. Authorized Official

Name: VINOD KUMAR
Title or Position: CEO / MEDICAL DIRECTOR
Credential: MD
Phone: 661-829-0074