Organization
OMNI FAMILY HEALTH
Active
Organization
OMNI FAMILY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANCISCO L CASTILLON (CHIEF EXECUTIVE OFFICER)
(661) 630-7050
Entity
Organization
Contact information
Practice address
655 S CENTRAL VALLEY HWY, SHATER, CA 93263-2790
(661) 459-1900
(661) 459-1974
Mailing address
4900 CALIFORNIA AVENUE, 400B, BAKERSFIELD, CA 93309-7081
(661) 459-1900
(661) 459-1974
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
CLN 1250
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70965F
—
CA
01
—
HAP70965F
FAMILY PACT
CA
05
—
PHA322610
—
CA
01
—
ZZZ24685Z
MEDICARE PART B
CA
Enumeration date
05/07/2007
Last updated
07/25/2018
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