Provider Demographics
NPI:1922578244
Name:UNIVERSAL HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:UNIVERSAL HEALTHCARE SERVICES, INC.
Other - Org Name:NILES CHILDREN'S CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-587-2468
Mailing Address - Street 1:8303 BRIMHALL RD BLDG 1500
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2243
Mailing Address - Country:US
Mailing Address - Phone:661-587-2468
Mailing Address - Fax:661-587-6403
Practice Address - Street 1:6055 NILES ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-4696
Practice Address - Country:US
Practice Address - Phone:661-587-2468
Practice Address - Fax:661-587-6403
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSAL HEALTHCARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-29
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty