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Organization
ZACOALCO MEDICAL GROUP INC
Active
Organization
ZACOALCO MEDICAL GROUP INC
Active
Parent organization
ZACOALCO MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ZACOALCO MEDICAL GROUP INC
Authorized official
MR. SAUL DE LA ROSA PAC (PRESIDENT)
(323) 588-1383
Entity
Organization
Contact information
Practice address
5901 NILES ST, A, BAKERSFIELD, CA 93306-4780
(166) 136-3723
Mailing address
5901 NILES ST, A, BAKERSFIELD, CA 93306-4780
(166) 163-6723
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G75144
CA
207V00000X
Obstetrics & Gynecology Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0080241
—
CA
Enumeration date
01/19/2007
Last updated
03/09/2018
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