Healthcare Provider Details
I. General information
NPI: 1073979043
Provider Name (Legal Business Name): PROXIMITY MD URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2016
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3409 CALLOWAY DR 101
BAKERSFIELD CA
93312-2528
US
IV. Provider business mailing address
3409 CALLOWAY DR 101
BAKERSFIELD CA
93312-2528
US
V. Phone/Fax
- Phone: 661-829-7050
- Fax: 661-829-7060
- Phone: 661-829-7050
- Fax: 661-829-7060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | G63146 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
ARMANDO
ALVAREZ
Title or Position: OWNER
Credential: MD
Phone: 661-829-7050