Healthcare Provider Details

I. General information

NPI: 1154673671
Provider Name (Legal Business Name): VALLEY MEDICAL GROUP OF KERN COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 10/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1147 7TH ST
WASCO CA
93280-1819
US

IV. Provider business mailing address

PO BOX 11510
BAKERSFIELD CA
93389-1510
US

V. Phone/Fax

Practice location:
  • Phone: 661-758-2449
  • Fax:
Mailing address:
  • Phone: 661-836-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number207R00000X
License Number StateCA

VIII. Authorized Official

Name: DR. CARLOS ALVAREZ
Title or Position: PRESIDENT
Credential:
Phone: 661-836-4000