Healthcare Provider Details
I. General information
NPI: 1225291925
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/03/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 STOCKDALE HWY SUITES 100 & 103
BAKERSFIELD CA
93311-3620
US
IV. Provider business mailing address
5080 SPECTRUM DR SUITE 1200 WEST TOWER
ADDISON TX
75001-4648
US
V. Phone/Fax
- Phone: 661-326-7536
- Fax: 661-321-0690
- Phone: 800-232-3550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TOM
FOGARTY
Title or Position: EVP CMO
Credential: MD
Phone: 800-232-3550