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Organization

PREMIER PHYSICIAN ALLIANCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD EVERETT CORNFORTH M.D. (PRESIDENT)
(661) 809-2005
Entity
Organization

Contact information

Practice address
5001 CALIFORNIA AVE STE 202, BAKERSFIELD, CA 93309-1692
(661) 809-2005
(661) 381-7546
Mailing address
PO BOX 2103, BAKERSFIELD, CA 93303-2103
(661) 809-2005
(661) 381-7545

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary

Other

Enumeration date
05/29/2007
Last updated
02/06/2024
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