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Organization
COVENANT COMMUNITY MEDICAL GROUP, INC.
Active
Organization
COVENANT COMMUNITY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARTNEY MICHELLE JACKSON (OFFICE MANAGER)
(661) 321-9206
Entity
Organization
Contact information
Practice address
3803 UNION AVE, BAKERSFIELD, CA 93305-2400
(661) 321-9206
(661) 321-0932
Mailing address
3803 UNION AVE, BAKERSFIELD, CA 93305-2400
(661) 321-9206
(661) 321-0932
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G41041
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G410410
—
CA
01
—
ZZZ27058Z
MEDICARE
CA
Enumeration date
09/29/2010
Last updated
02/24/2011
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