Basic Information
| Provider Information | |||||||||
| NPI: | 1487776969 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHEAST WALK-IN CLINIC, A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 OSWELL ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933063156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618729999 | ||||||||
| FaxNumber: | 6618721915 | ||||||||
| Practice Location | |||||||||
| Address1: | 2601 OSWELL ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933063156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618729999 | ||||||||
| FaxNumber: | 6618721915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2007 | ||||||||
| LastUpdateDate: | 01/14/2010 | ||||||||
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| AuthorizedOfficialLastName: | RAHIMIFAR | ||||||||
| AuthorizedOfficialFirstName: | MAJID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6618729999 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.