| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1100 4th St, Taft, California |
| Authorized Official Name and Position | Francisco L Castillon (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6616307050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4900 California Ave 400b Bakersfield CA 93309-7081 Ph: (661) 459-1900 | 1100 4th St Taft CA 93268-2415 Ph: (866) 707-6664 |
| NPI Number | 1699780536 |
|---|---|
| Provider Enumeration Date | 07/29/2006 |
| Last Update Date | 09/24/2024 |
| Medicare PECOS PAC ID | 9234176363 |
|---|---|
| Medicare Enrollment ID | O20100625000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699780536 | NPI | - | NPPES |
| BCP70511F | Other | CA | CDHS |
| FHC70511F | Medicaid | CA | |
| HAP70511F | Other | CA | DHCS/FAMILY PACT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 120000303 (California) | Primary |
Charles J. Walker, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Center St, Taft, CA 93268 Phone: 661-763-1501 Fax: 661-763-4360 | |
J. Sterling Bryan, D.d.s., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 6th St, Taft, CA 93268 Phone: 661-763-4161 Fax: 661-763-1951 |