COVENANT COMMUNITY MEDICAL GROUP INC. NPI 1942519558

NPI Information

NPI: 1942519558
Provider Name: COVENANT COMMUNITY MEDICAL GROUP, INC.
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
3803 UNION AVE
BAKERSFIELD, CA
ZIP 93305
Phone: (661) 321-9206
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COVENANT COMMUNITY MEDICAL GROUP, INC. is a general practice in Bakersfield, CA. COVENANT COMMUNITY MEDICAL GROUP, INC. NPI is 1942519558. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3803 UNION AVE
BAKERSFIELD, CA
ZIP 93305-400
Phone: (661) 321-9206
Fax: (661) 321-0932

The provider's authorized official is Artney Michelle Jackson .
The authorized official title is Office Manager and has the following contact phone number (661) 321-9206.

The enumeration date for this NPI number is 9/29/2010 and was last updated on 2/24/2011.

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
1	208D00000X	General Practice		G41041	CALIFORNIA	Yes

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
1	ZZZ27058Z	OTHER	CALIFORNIA	MEDICARE
2	F20052	MEDICARE UPIN	CALIFORNIA
3	00G410410	MEDICAID	CALIFORNIA

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: 11/14/2023

NPI Synchronization or Removal

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