NPIMap

Organization Active NPI

California Department of Correction/ Rehabilitation

  • Prison Health Clinic/Center
  • Tehachapi, CA
National Provider Identifier
1699027730
Registry record updated Oct 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
License
A63214 Issued in CA
Legal business name
CALIFORNIA DEPARTMENT OF CORRECTION/ REHABILITATION
Practice address
24900 Highway 202
Tehachapi, CA 93561-5558
Phone
(661) 822-4402
NPI assigned
Oct 14, 2012
Last updated
Oct 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2012

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

Authorized official

Name
Dr. Nguyet Minh Dam, MD
Title
Staff Psychiatrist
Phone
(661) 822-4402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X A63214 CA Primary

Addresses

Primary practice location

24900 Highway 202
Tehachapi, CA 93561-5558

Mailing address

24900 Highway 202
Tehachapi, CA 93561-5558
Phone (661) 822-4402

Other names 1

  • Department C&R CORR Institution/ Tehachapi Other name

National Provider Directory

National Provider Directory
Tax ID family
State of California Prison Industry Authority30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1350172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350172800000",
    "number": "1699027730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24900 HIGHWAY 202",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935615558",
            "telephone_number": "661-822-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24900 HIGHWAY 202",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935615558",
            "telephone_number": "661-822-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA DEPARTMENT OF CORRECTION/ REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-14",
        "last_updated": "2012-10-14",
        "status": "A",
        "authorized_official_last_name": "DAM",
        "authorized_official_first_name": "NGUYET",
        "authorized_official_middle_name": "MINH",
        "authorized_official_title_or_position": "STAFF PSYCHIATRIST",
        "authorized_official_telephone_number": "661-822-4402",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "CA",
            "license": "A63214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department C&R CORR Institution/ Tehachapi",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tehachapi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2012; 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.