Mel Clark Requias Taveros, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A139158 Issued in CA

Practice address

301 Brundage LN
Bakersfield, CA 93304-3248

Phone

(661) 323-6086

Fax

(661) 324-6301

NPI assigned

Dec 28, 2011

Last updated

Dec 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  dba Pinnacle Emergency Physicians of Bakersfield A Professional

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1619153251
  Medicare reassignment NPD
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1639415862
  NPD

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1982973582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021559",
            "telephone_number": "661-635-3050",
            "fax_number": "661-635-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BRUNDAGE LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933043248",
            "telephone_number": "661-323-6086",
            "fax_number": "661-324-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVEROS",
        "first_name": "MEL CLARK",
        "middle_name": "REQUIAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-28",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A139158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Paul Tate, PA-C
• Tatsuno Chiropracitc Inc
• William Stuart Tatsuno D.C., D.C.
• Matthew George Tatsuno, D.C.
• Bianca Jasmine Tavera
• Ebram L Tawdrous, RPH
• Hanan Tawfik
• Marcelle Tawfik
• Peter Tawfik
• Hassan Tayabli, RPH

• Pediatrics Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.