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Organization
IMPACT PHYSICIAN GROUP - CALIFORNIA PC
Active
Organization
IMPACT PHYSICIAN GROUP - CALIFORNIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL MILLER (CEO)
(678) 967-5599
Entity
Organization
Contact information
Practice address
4400 KIRKCALDY DR, BAKERSFIELD, CA 93306-5542
(661) 688-7000
Mailing address
21 EASTBROOK BND STE 218, PEACHTREE CITY, GA 30269-1546
(678) 967-5599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
11/04/2022
Last updated
12/20/2022
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