Healthcare Provider Details

I. General information

NPI: 1629341409
Provider Name (Legal Business Name): ALTERNATIVE MEDICAL MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 JEFFERSON ST
DELANO CA
93215-2263
US

IV. Provider business mailing address

526 LEWISHAM ST
BAKERSFIELD CA
93311-3583
US

V. Phone/Fax

Practice location:
  • Phone: 661-634-9900
  • Fax: 661-634-0973
Mailing address:
  • Phone: 661-634-9900
  • Fax: 661-634-0973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC9240
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC21359
License Number StateCA

VIII. Authorized Official

Name: DR. RUDY B HERRERA
Title or Position: OWNER
Credential: DC
Phone: 661-634-9900