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General NPI Number Information
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NPI Number | 1760877245
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Entity Type | Organization
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Legal Business Name | VALLEY CHILDREN'S PRIMARY CARE GROUP, INC.
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 500 40TH ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1224
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Country | US
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Telephone | 661-327-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 9300 VALLEY CHILDRENS PL
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City | MADERA
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State | CA
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Zip | 93636-8761
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Country | US
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Telephone | 559-353-3000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID CHRISTENSEN
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Credential | M.D.
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Telephone | 559-353-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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