Provider Demographics
NPI:1588609762
Name:STRATEGOS MEDICAL CORPORATION
Entity Type:Organization
Organization Name:STRATEGOS MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRATEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-654-0400
Mailing Address - Street 1:PO BOX 2326
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-2326
Mailing Address - Country:US
Mailing Address - Phone:661-654-0400
Mailing Address - Fax:661-654-2633
Practice Address - Street 1:9330 STOCKDALE HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3614
Practice Address - Country:US
Practice Address - Phone:661-654-0400
Practice Address - Fax:661-654-2633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0088440Medicaid
CAGR0088440Medicaid
CACB3889Medicare ID - Type UnspecifiedRR MEDICARE