Healthcare Provider Details

I. General information

NPI: 1275161325
Provider Name (Legal Business Name): CLINICA SIERRA VISTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 HALL RD RM A
LAMONT CA
93241-1953
US

IV. Provider business mailing address

1430 TRUXTUN AVENUE, STE 400
BAKERSFIELD CA
93301-5220
US

V. Phone/Fax

Practice location:
  • Phone: 661-835-6953
  • Fax: 888-910-5286
Mailing address:
  • Phone: 661-635-3050
  • Fax: 661-732-3064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. OLGA MEAVE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 661-635-3050