Healthcare Provider Details

I. General information

NPI: 1942753728
Provider Name (Legal Business Name): OMNI FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N CHESTER AVE
BAKERSFIELD CA
93308-4841
US

IV. Provider business mailing address

4900 CALIFORNIA AVE
BAKERSFIELD CA
93309-7024
US

V. Phone/Fax

Practice location:
  • Phone: 661-237-6600
  • Fax: 661-237-6650
Mailing address:
  • Phone: 661-459-1900
  • Fax: 661-459-1974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO L CASTILLON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 661-630-7050