Healthcare Provider Details

I. General information

NPI: 1417881947
Provider Name (Legal Business Name): VANGUARD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 KERN ST
SHAFTER CA
93263-2133
US

IV. Provider business mailing address

555 KERN ST
SHAFTER CA
93263-2133
US

V. Phone/Fax

Practice location:
  • Phone: 661-459-1030
  • Fax: 661-459-3535
Mailing address:
  • Phone: 661-459-1030
  • Fax: 661-459-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NOVIRA SUNNER
Title or Position: ADMINISTRATOR
Credential:
Phone: 661-599-5310