Provider Demographics
NPI:1558387985
Name:ALFAFARA, PAMELA ANTONIETTA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANTONIETTA
Last Name:ALFAFARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:ANTONIETTA
Other - Last Name:ALFAFARA-ORTIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5500 MING AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4689
Mailing Address - Country:US
Mailing Address - Phone:661-834-8341
Mailing Address - Fax:661-834-6095
Practice Address - Street 1:5500 MING AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4689
Practice Address - Country:US
Practice Address - Phone:661-834-8341
Practice Address - Fax:661-834-6095
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC514712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG86366Medicare UPIN
CA00C514710Medicare PIN