| Central Valley Medical Group | |
|
1925 17th St Bakersfield CA 93301-4201 | |
| (661) 323-2295 | |
| (661) 323-8040 |
| Full Name | Central Valley Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 1925 17th St, Bakersfield, California |
| Authorized Official Name and Position | Ronnie Claiborne (PRESIDENT) |
| Authorized Official Contact | 6613232295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Valley Medical Group 1925 17th St Bakersfield CA 93301-4201 Ph: (661) 323-2295 | Central Valley Medical Group 1925 17th St Bakersfield CA 93301-4201 Ph: (661) 323-2295 |
| NPI Number | 1003057498 |
|---|---|
| Provider Enumeration Date | 03/13/2009 |
| Last Update Date | 03/13/2009 |
| Medicare PECOS PAC ID | 5991959959 |
|---|---|
| Medicare Enrollment ID | O20130129000517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003057498 | NPI | - | NPPES |
| 00G666491 | Medicaid | CA | |
| 1578503256 | Other | CA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | G66649 (California) | Primary |
| Provider Name | Ronnie Claiborne |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578503256 PECOS PAC ID: 1557374956 Enrollment ID: I20060802000288 |
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