Provider Demographics
NPI:1376725374
Name:VALLEY MEDICAL GROUP OF KERN COUNTY, INC.
Entity Type:Organization
Organization Name:VALLEY MEDICAL GROUP OF KERN COUNTY, INC.
Other - Org Name:WHITE LANE URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ARTURO
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-836-4000
Mailing Address - Street 1:PO BOX 11510
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-1510
Mailing Address - Country:US
Mailing Address - Phone:661-836-4000
Mailing Address - Fax:661-847-4097
Practice Address - Street 1:5401 WHITE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-6279
Practice Address - Country:US
Practice Address - Phone:661-836-4000
Practice Address - Fax:661-847-4097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP36600261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27605ZMedicare PIN