Healthcare Provider Details

I. General information

NPI: 1194276261
Provider Name (Legal Business Name): VALLEY CHILDREN'S MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 STOCKDALE HWY SUITE 105
BAKERSFIELD CA
93311-3632
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 661-410-9500
  • Fax: 661-410-9501
Mailing address:
  • Phone: 559-353-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL GOLDRING
Title or Position: CHIEF ADMINISTRATIVE OFFICE
Credential:
Phone: 559-353-5010