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General NPI Number Information
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NPI Number | 1740278720
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 2800 K ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-2041
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Country | US
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Telephone | 661-631-1882
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Fax | 661-631-9716
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Provider Business Mailing Address
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Address Line | 2800 K ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-2041
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Country | US
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Telephone | 661-869-6700
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Fax | 661-631-9716
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. BRENT SOPER
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Credential |
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Telephone | 661-395-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 120000251
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License Number State | CA
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