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General NPI Number Information
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NPI Number | 1295992196
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Entity Type | Organization
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Legal Business Name | OMNIPSYCH A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 820 34TH ST 102
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City | BAKERSFIELD
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State | CA
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Zip | 93301-2283
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Country | US
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Telephone | 661-324-4434
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Fax | 661-324-4464
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Provider Business Mailing Address
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Address Line | 655 S FLOWER ST 368
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City | LOS ANGELES
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State | CA
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Zip | 90017-2805
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Country | US
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Telephone | 213-430-9180
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Fax | 213-430-9193
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLIFFORD F. FELDMAN
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Credential | M.D.
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Telephone | 213-430-9180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | G78112
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License Number State | CA
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