Healthcare Provider Details

I. General information

NPI: 1649381807
Provider Name (Legal Business Name): CENTRAL CALIFORNIA HOSPITALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 GARCES HWY
DELANO CA
93215
US

IV. Provider business mailing address

PO BOX 12798
BAKERSFIELD CA
93389-2798
US

V. Phone/Fax

Practice location:
  • Phone: 661-332-3355
  • Fax: 661-859-1209
Mailing address:
  • Phone: 661-332-3355
  • Fax: 661-332-3355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAKTI SRIVASTAVA
Title or Position: OWNER
Credential: MD
Phone: 661-332-3355