Provider Demographics
NPI:1780194431
Name:PREMIER INTEGRATED CARE CLINIC, INC.
Entity Type:Organization
Organization Name:PREMIER INTEGRATED CARE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARJEET
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-396-7100
Mailing Address - Street 1:6313 SCHIRRA CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-2174
Mailing Address - Country:US
Mailing Address - Phone:661-396-7100
Mailing Address - Fax:661-735-8911
Practice Address - Street 1:6313 SCHIRRA CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2174
Practice Address - Country:US
Practice Address - Phone:661-396-7100
Practice Address - Fax:661-735-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty