Provider Demographics
NPI:1871272427
Name:TELEHEALTHDOCS MEDICAL CORPORATION
Entity type:Organization
Organization Name:TELEHEALTHDOCS MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:QUON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-840-9270
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-0068
Mailing Address - Country:US
Mailing Address - Phone:661-840-9270
Mailing Address - Fax:661-864-7848
Practice Address - Street 1:801 SANTA FE WAY
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263-3158
Practice Address - Country:US
Practice Address - Phone:661-840-9270
Practice Address - Fax:661-864-7848
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TELEHEALTHDOCS MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA700665541OtherMEDI-CAL