Provider Demographics
NPI:1750516951
Name:BUENA VISTA EMERGENCY MEDICAL SERVICES
Entity type:Organization
Organization Name:BUENA VISTA EMERGENCY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:661-316-6000
Mailing Address - Street 1:PO BOX 21851
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-1851
Mailing Address - Country:US
Mailing Address - Phone:661-316-6000
Mailing Address - Fax:661-524-0448
Practice Address - Street 1:3001 SILLECT AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6337
Practice Address - Country:US
Practice Address - Phone:661-316-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA905AMedicare PIN