Organization
CCS MEDICAL THERAPY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW CONSTANTINE (DIRECTOR OF PUBLIC HEALTH SERVICES)
(661) 868-0301
Entity
Organization
Contact information
Practice address
601 4TH ST, BAKERSFIELD, CA 93304-2221
(661) 868-7270
Mailing address
1800 MT VERNON AVE, BAKERSFIELD, CA 93306
(661) 868-0358
(661) 868-0268
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCS00107
—
CA
Enumeration date
01/22/2007
Last updated
07/21/2022
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