Basic Information
| Provider Information | |||||||||
| NPI: | 1619956976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOSBINDER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | JOE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21851 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933901851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613166000 | ||||||||
| FaxNumber: | 6615240448 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 SILLECT AVE | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933086337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613166000 | ||||||||
| FaxNumber: | 6615240448 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 06/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 20A9214 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00AX92140 | 01 | CA | MEDI-CAL | OTHER |