| Premier Valley Medical Group | |
|
5401 White Ln Bakersfield CA 93309-6279 | |
| (661) 396-7100 | |
| (661) 396-7101 |
| Full Name | Premier Valley Medical Group |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 5401 White Ln, Bakersfield, California |
| Authorized Official Name and Position | Moncy Rachel John (FNP) |
| Authorized Official Contact | 6613967100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Valley Medical Group 10314 Sterling Silver St Bakersfield CA 93311-9524 Ph: (661) 303-7201 | Premier Valley Medical Group 5401 White Ln Bakersfield CA 93309-6279 Ph: (661) 396-7100 |
| NPI Number | 1578900148 |
|---|---|
| Provider Enumeration Date | 05/23/2013 |
| Last Update Date | 11/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578900148 | NPI | - | NPPES |
| 1578900148 | Other | CA | NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 23810 (California) | Secondary |
| 282N00000X | General Acute Care Hospital | 650527 (California) | Primary |
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