Organization Name: | ABUNDANT WELLNESS AND MEDICAL CENTER INC |
NPI Number: | 1851568919 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VINCENT STEVEN BOOTH (VICE PRESIDENT) |
Mailing Address: | 1927 21st St Bakersfield |
State: | CA US |
Postal Code: | 933014217 |
Phone Number: | 6613244431 |
Fax Number: | 6613245616 |
NPI Enumeration Date: | 05/08/2008 |
NPI Last Update Date: | 04/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |