Healthcare Provider Details

I. General information

NPI: 1407332919
Provider Name (Legal Business Name): IDALBERTO ZALDIVAR GALVES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 SILLECT AVE STE 201
BAKERSFIELD CA
93308-6373
US

IV. Provider business mailing address

1115 S SUNSET AVE
WEST COVINA CA
91790-3940
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-2101
  • Fax: 661-327-2554
Mailing address:
  • Phone: 626-813-2850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA173456
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: