Provider Demographics
NPI:1730570565
Name:24 ON PHYSICIANS OF CALIFORNIA, P.C.
Entity type:Organization
Organization Name:24 ON PHYSICIANS OF CALIFORNIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAYOR CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:REYNOLDS
Authorized Official - Last Name:ALBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-274-0468
Mailing Address - Street 1:PO BOX 19107
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4086
Mailing Address - Country:US
Mailing Address - Phone:770-274-0468
Mailing Address - Fax:404-806-4334
Practice Address - Street 1:465 W PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3320
Practice Address - Country:US
Practice Address - Phone:559-791-3880
Practice Address - Fax:559-791-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty