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General NPI Number Information
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NPI Number | 1972761997
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN URGENT CARE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 901 OLIVE DR
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City | BAKERSFIELD
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State | CA
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Zip | 93308-4137
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Country | US
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Telephone | 661-215-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 TRUXTUN AVE SUITE 160
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-323-6410
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | LUCINDA LEE FERRIS
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Credential |
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Telephone | 661-215-7669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | FNP23615
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License Number State | CA
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