| Form Health Associates, P.c. | |
|
4900 California Avenue Tower B, 2nd Floor Bakersfield CA 93309-7024 | |
| (617) 505-1520 | |
| (617) 928-8401 |
| Full Name | Form Health Associates, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4900 California Avenue, Bakersfield, California |
| Authorized Official Name and Position | Nam Ho Kim (PRESIDENT) |
| Authorized Official Contact | 6175051520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Form Health Associates, P.c. 109 State Street 5th Fl Boston MA 02109-2906 Ph: (617) 505-1520 | Form Health Associates, P.c. 4900 California Avenue Tower B, 2nd Floor Bakersfield CA 93309-7024 Ph: (617) 505-1520 |
| NPI Number | 1043835044 |
|---|---|
| Provider Enumeration Date | 06/15/2020 |
| Last Update Date | 03/18/2026 |
| Medicare PECOS PAC ID | 0244641272 |
|---|---|
| Medicare Enrollment ID | O20201124001275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043835044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Jennifer M Black |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194763326 PECOS PAC ID: 6305735739 Enrollment ID: I20071005000813 |
| Provider Name | Angelica R Neison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770787137 PECOS PAC ID: 3173718889 Enrollment ID: I20101108000935 |
| Provider Name | Lisa M Gause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932302973 PECOS PAC ID: 6002097367 Enrollment ID: I20110221000665 |
| Provider Name | Michelle Cao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003129842 PECOS PAC ID: 9638328370 Enrollment ID: I20121012000428 |
| Provider Name | Lauren Marshall Lemieux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912393463 PECOS PAC ID: 5799030458 Enrollment ID: I20180620002233 |
| Provider Name | Melanie Joy Madriaga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144717836 PECOS PAC ID: 4587099403 Enrollment ID: I20200908001379 |
| Provider Name | Nathaniel M Pedley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669978532 PECOS PAC ID: 4486082898 Enrollment ID: I20210622003552 |
Ronnie Claiborne M.d. A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1925 17th St, Bakersfield, CA 93301 Phone: 661-323-2295 Fax: 661-323-8040 | |
Kern County Hospital Authority Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1111 Columbus St Ste 3000, Bakersfield, CA 93305 Phone: 661-664-2200 | |
Nadim Sarkies M.d., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2001 F St, Bakersfield, CA 93301 Phone: 661-325-7000 Fax: 661-325-7050 | |
Valley Medical Group Of Kern County, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5401 White Ln, Bakersfield, CA 93309 Phone: 661-836-4000 Fax: 661-847-4097 | |
Sound Inpatient Physicians Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2615 Chester Ave, Bakersfield, CA 93301 Phone: 661-935-3000 | |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9330 Stockdale Hwy, Suite 400, Bakersfield, CA 93311 Phone: 661-654-0400 Fax: 661-323-0889 | |
Qualcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3008 Sillect Ave Ste 100, Bakersfield, CA 93308 Phone: 661-371-2790 Fax: 661-371-3498 |