Provider Demographics
NPI:1750872255
Name:UNIVERSAL OCCUPATIONAL MEDICINE PC
Entity type:Organization
Organization Name:UNIVERSAL OCCUPATIONAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
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:661-587-2648
Mailing Address - Fax:661-587-6403
Practice Address - Street 1:8303 BRIMHALL RD BLDG 1500
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2243
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 URGENT CARE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherOCCUPATIONAL MEDICINE