Provider Demographics
NPI:1629341409
Name:ALTERNATIVE MEDICAL MANAGEMENT
Entity Type:Organization
Organization Name:ALTERNATIVE MEDICAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:B
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-634-9900
Mailing Address - Street 1:526 LEWISHAM ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3583
Mailing Address - Country:US
Mailing Address - Phone:661-634-9900
Mailing Address - Fax:661-634-0973
Practice Address - Street 1:1224 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2263
Practice Address - Country:US
Practice Address - Phone:661-634-9900
Practice Address - Fax:661-634-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21359111N00000X
CAAC9240171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24305Medicare UPIN