Provider Demographics
NPI:1649381807
Name:CENTRAL CALIFORNIA HOSPITALISTS
Entity Type:Organization
Organization Name:CENTRAL CALIFORNIA HOSPITALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKTI
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIVASTAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-332-3355
Mailing Address - Street 1:PO BOX 12798
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-2798
Mailing Address - Country:US
Mailing Address - Phone:661-332-3355
Mailing Address - Fax:661-332-3355
Practice Address - Street 1:1401 GARCES HWY
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215
Practice Address - Country:US
Practice Address - Phone:661-332-3355
Practice Address - Fax:661-859-1209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2018-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0103731OtherMEDI-CAL-MERCY SW
CAGR0103730OtherMEDI-CAL-MERCY TRUXTUN
CAZZZ03931ZMedicare ID - Type Unspecified