Organization
FERNANDO B BRAVO MD INC
Active
Organization
FERNANDO B BRAVO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FERNANDO B. BRAVO M.D. (PRESIDENT/PHYSICIAN)
(661) 327-4712
Entity
Organization
Contact information
Practice address
3110 LATTE LANE, BAKERSFIELD, CA 93312-2141
(661) 327-4712
(661) 327-4004
Mailing address
PO BOX 20207, BAKERSFIELD, CA 93390-0207
(661) 327-4712
(661) 327-4004
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A72360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A723600
—
CA
01
—
DF3572
RAILROAD MEDICARE
CA
Enumeration date
06/02/2006
Last updated
08/28/2013
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