Provider Demographics
NPI:1629541685
Name:PINNACLE PRIMARY CARE INC.
Entity Type:Organization
Organization Name:PINNACLE PRIMARY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EURAL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:NP PAC
Authorized Official - Phone:661-321-9138
Mailing Address - Street 1:1520 BRUNDAGE LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-2949
Mailing Address - Country:US
Mailing Address - Phone:661-321-9138
Mailing Address - Fax:661-321-9186
Practice Address - Street 1:1520 BRUNDAGE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-2949
Practice Address - Country:US
Practice Address - Phone:661-321-9138
Practice Address - Fax:661-321-9186
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE PRIMARY CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-02
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty