Provider Demographics
NPI:1487776969
Name:NORTHEAST WALK-IN CLINIC, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:NORTHEAST WALK-IN CLINIC, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMIFAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-872-9999
Mailing Address - Street 1:2601 OSWELL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3156
Mailing Address - Country:US
Mailing Address - Phone:661-872-9999
Mailing Address - Fax:661-872-1915
Practice Address - Street 1:2601 OSWELL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3156
Practice Address - Country:US
Practice Address - Phone:661-872-9999
Practice Address - Fax:661-872-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty