Provider Demographics
NPI:1811147853
Name:DR ORIENTE M ESPOSO A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:DR ORIENTE M ESPOSO A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-843-7841
Mailing Address - Street 1:4208 ROSEDALE HWY
Mailing Address - Street 2:SUITE 302 337
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6170
Mailing Address - Country:US
Mailing Address - Phone:661-843-7841
Mailing Address - Fax:661-864-7943
Practice Address - Street 1:4208 ROSEDALE HWY
Practice Address - Street 2:SUITE 302 337
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6170
Practice Address - Country:US
Practice Address - Phone:661-843-7841
Practice Address - Fax:661-864-7943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42316174400000X, 313M00000X
CA00A42316282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42316Medicaid
CAA42316Medicaid
CABL168Medicare PIN