# INDEPENDENCE IPA, A MEDICAL GROUP, INC. DBA INDEPENDENCE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Independence Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588804777
- **Authorized official:** KRISTY SVENSON (NETWORK DIRECTOR)
- **Authorized official phone:** (866) 814-4476

## Contact information

- **Practice address:** 1801 16TH ST, SUITE B, BAKERSFIELD, CA 93301-5002
- **Practice address phone:** (866) 814-4476
- **Practice address fax:** (866) 814-4478
- **Mailing address:** 1801 16TH ST, SUITE B, BAKERSFIELD, CA 93301-5002
- **Mailing address phone:** (866) 814-4476
- **Mailing address fax:** (866) 814-4478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 02/27/2009
- **Last updated:** 02/27/2009