Healthcare Provider Details

I. General information

NPI: 1609171727
Provider Name (Legal Business Name): TAFT MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CENTER ST
TAFT CA
93268-3511
US

IV. Provider business mailing address

PO BOX 1079
TAFT CA
93268-1079
US

V. Phone/Fax

Practice location:
  • Phone: 661-769-9930
  • Fax:
Mailing address:
  • Phone: 661-769-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDA ROBERTS
Title or Position: CEO
Credential: RN
Phone: 559-752-4147