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Organization
ST. THERESE MEDICAL GROUP
Active
Organization
ST. THERESE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY FERRIS (ADMINISTRATOR)
(661) 391-0305
Entity
Organization
Contact information
Practice address
511 W COLUMBUS ST, BAKERSFIELD, CA 93301-1201
(661) 391-0305
(661) 391-0313
Mailing address
7702 MEANY AVE, SUITE 105, BAKERSFIELD, CA 93308-5199
(661) 391-0305
(661) 391-0313
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A42316
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A42316
LICENSE
CA
05
—
GR0083054
—
CA
Enumeration date
06/20/2005
Last updated
01/03/2019
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