| Fernando B Bravo Md Inc | |
|
3110 Latte Lane Bakersfield CA 93312-2141 | |
| (661) 327-4712 | |
| (661) 327-4004 |
| Full Name | Fernando B Bravo Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3110 Latte Lane, Bakersfield, California |
| Authorized Official Name and Position | Fernando B. Bravo (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 6613274712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fernando B Bravo Md Inc Po Box 20207 Bakersfield CA 93390-0207 Ph: (661) 327-4712 | Fernando B Bravo Md Inc 3110 Latte Lane Bakersfield CA 93312-2141 Ph: (661) 327-4712 |
| NPI Number | 1043257314 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 08/28/2013 |
| Medicare PECOS PAC ID | 6507877198 |
|---|---|
| Medicare Enrollment ID | O20060510000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043257314 | NPI | - | NPPES |
| DF3572 | Other | CA | RAILROAD MEDICARE |
| 00A723600 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A72360 (California) | Primary |
| Provider Name | Fernando B Bravo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245262104 PECOS PAC ID: 0749266112 Enrollment ID: I20040625001158 |
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