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NPI Code Detail

MEDICARE: MATHIAS EL TRIBE

MEDICARE: MATHIAS EL TRIBE
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
1332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

General Provider Information

NPI Number : 1790542223
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATHIAS EL TRIBE
Provider Business Mailing Address
First Line : PO BOX 78771
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93383-8771
Country : US
Telephone Number : 818-477-7244
Fax Number :
Provider Business Practice Location Address
First Line : MATHIAS EL TRIBE
Second Line : 4305 SUN DEVILS AVENUE
City : BAKERSFIELD
State : CA
Zip : 93313-9331
Country : US
Telephone Number : 818-477-7244
Fax Number :
Authorized Official
Title or Position : CHIEF MATHIAS EL (CTH)
Name : MATHEW ALLEN MCCASTER
Credential : NURSE PRACTITIONER
Telephone Number : 818-477-7244
Provider Enumeration Date : 03/01/2024
Last Update Date : 08/02/2024

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Directions to “MATHIAS EL TRIBE ” Practice Location

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