MEDICARE: CALIDAD MEDICAL HEALTH CARE GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1538412572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIDAD MEDICAL HEALTH CARE GROUP

Provider Business Mailing Address
First Line	:	1326 H ST
Second Line	:	1
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5134
Country	:	US
Telephone Number	:	213-709-4274
Fax Number	:

Provider Business Practice Location Address
First Line	:	1326 H ST
Second Line	:	1
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5134
Country	:	US
Telephone Number	:	213-709-4274
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ERNEST YBARRA CASILLAS
Credential	:	MD
Telephone Number	:	213-709-4274

Provider Enumeration Date	:	10/15/2012
Last Update Date	:	10/04/2013

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