Provider Demographics
NPI:1609171727
Name:TAFT MEDICAL CLINIC
Entity Type:Organization
Organization Name:TAFT MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:559-752-4147
Mailing Address - Street 1:PO BOX 1079
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-1079
Mailing Address - Country:US
Mailing Address - Phone:661-769-9930
Mailing Address - Fax:
Practice Address - Street 1:400 CENTER ST
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3511
Practice Address - Country:US
Practice Address - Phone:661-769-9930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service