Provider Demographics
NPI:1215786538
Name:MATHIAS EL TRIBE CHARITABLE TRUST
Entity type:Organization
Organization Name:MATHIAS EL TRIBE CHARITABLE TRUST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MATHIAS EL/ CTH
Authorized Official - Prefix:
Authorized Official - First Name:MATHEW-ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:818-477-7244
Mailing Address - Street 1:MATHIAS EL TRIBE
Mailing Address - Street 2:4305 SUN DEVILS AVENUE
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313
Mailing Address - Country:US
Mailing Address - Phone:818-477-7244
Mailing Address - Fax:
Practice Address - Street 1:4305 SUN DEVILS AVENUE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313
Practice Address - Country:US
Practice Address - Phone:818-477-7244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MATHIAS EL TRIBE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-17
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No347C00000XTransportation ServicesPrivate Vehicle