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General NPI Number Information
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NPI Number | 1649076506
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Entity Type | Organization
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Legal Business Name | MAMA VEGA ENTERPRISES
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1512 18TH ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-4402
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Country | US
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Telephone | 661-532-8342
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Fax |
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Provider Business Mailing Address
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Address Line | 10019 ALLSPICE ROSE CT
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City | BAKERSFIELD
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State | CA
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Zip | 93311-3763
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Country | US
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Telephone | 661-532-8342
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARMENE MARJORIE VEGA
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Credential | MS, D.H.L. (H.C.)
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Telephone | 661-532-8342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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