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WINDY CITY MEDICAL CLINIC A PROFESSIONAL CORPORATION NPI 1164567426


NPI Information

NPI: 1164567426
Provider Name: WINDY CITY MEDICAL CLINIC A PROFESSIONAL CORPORATION
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 05D0970431

Address:
525 MELISSA AVE STE A
BARSTOW, CA
ZIP 92311
Phone: (760) 255-2400
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WINDY CITY MEDICAL CLINIC A PROFESSIONAL CORPORATION is a primary care clinic center in Barstow, CA. WINDY CITY MEDICAL CLINIC A PROFESSIONAL CORPORATION NPI is 1164567426. The provider is registered as an organization entity type.

The provider's business location address is:

525 MELISSA AVE STE A
BARSTOW, CA
ZIP 92311-002
Phone: (760) 255-2400
Fax: (760) 957-7517

The provider's authorized official is Kathy A Alva .
The authorized official title is Billing Office Manager and has the following contact phone number (760) 957-7510.

The CLIA number assigned to this NPI record is 05D0970431 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 12/29/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100G778040MEDICARE PINCALIFORNIA
200G778042MEDICARE PINCALIFORNIA
3ZZZ07612ZMEDICARE PINCALIFORNIA
400G778041MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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