NPIMap

Organization Active NPI

Polyclinic Medical Center, Inc.

  • Community/Behavioral Health Agency
  • Bakersfield, CA
National Provider Identifier
1053589598
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
G58893 Issued in CA
Legal business name
POLYCLINIC MEDICAL CENTER, INC.
Practice address
2145 Niles St
Bakersfield, CA 93305-5007
Phone
(661) 327-5984
Fax
(661) 327-3831
NPI assigned
Feb 19, 2008
Last updated
Aug 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Juan A. Monterroso, M.D.
Title
Doctor
Phone
(661) 327-5984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X G58893 CA Primary

Addresses

Primary practice location

2145 Niles St
Bakersfield, CA 93305-5007

Mailing address

2145 Niles St
Bakersfield, CA 93305-5007
Phone (661) 327-5984

Other identifiers 2

IdentifierTypeStateIssuer
CMM70507HMedicaidCA
GR0084450MedicaidCA

National Provider Directory

National Provider Directory

Locations

2145 Niles St
Bakersfield, CA 93305
Phone (661) 327-5984

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIAIBD

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1053589598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055007",
            "telephone_number": "661-327-5984",
            "fax_number": "661-327-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055007",
            "telephone_number": "661-327-5984",
            "fax_number": "661-327-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLYCLINIC MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "MONTERROSO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "661-327-5984",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "G58893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70507H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.