=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316645518
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEGACY CARING PARTNERS CO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2023
-----------------------------------------------------
Last Update Date | 02/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4900 CALIFORNIA AVE STE 210B
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-7080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-376-0241
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4900 CALIFORNIA AVE STE 210B
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-7080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-376-0241
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ELVER GUARDADO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-742-9573
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176P00000X
-----------------------------------------------------
Taxonomy Name | Funeral Director
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------