Healthcare Provider Details

I. General information

NPI: 1811147853
Provider Name (Legal Business Name): DR ORIENTE M ESPOSO A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 ROSEDALE HWY SUITE 302 337
BAKERSFIELD CA
93308-6170
US

IV. Provider business mailing address

4208 ROSEDALE HWY SUITE 302 337
BAKERSFIELD CA
93308-6170
US

V. Phone/Fax

Practice location:
  • Phone: 661-843-7841
  • Fax: 661-864-7943
Mailing address:
  • Phone: 661-843-7841
  • Fax: 661-864-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number00A42316
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberA42316
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA42316
License Number StateCA

VIII. Authorized Official

Name: MRS. DENISE M PITTS
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 661-843-7841