Provider Demographics
NPI:1699812917
Name:FOUNDATION FOR MEDICAL CARE OF TULARE KINGS COUNTIES INC
Entity Type:Organization
Organization Name:FOUNDATION FOR MEDICAL CARE OF TULARE KINGS COUNTIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-734-1321
Mailing Address - Street 1:3335 S FAIRWAY ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-7781
Mailing Address - Country:US
Mailing Address - Phone:559-734-1321
Mailing Address - Fax:559-734-0431
Practice Address - Street 1:3335 S FAIRWAY ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7781
Practice Address - Country:US
Practice Address - Phone:559-734-1321
Practice Address - Fax:559-734-0431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization