Provider Demographics
NPI:1235215906
Name:EAST HILLS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:EAST HILLS MEDICAL GROUP INC
Other - Org Name:EAST HILLS PLAZA MEDICAL ASSOCIATES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF BANKING OFFICER OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:DODENHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-871-3514
Mailing Address - Street 1:PO BOX 6399
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93386
Mailing Address - Country:US
Mailing Address - Phone:661-871-3514
Mailing Address - Fax:661-325-7199
Practice Address - Street 1:2010 17TH STREET
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301
Practice Address - Country:US
Practice Address - Phone:661-871-3514
Practice Address - Fax:661-325-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center