1184687782 NPI number — DR. SARUPINDER SINGH BHANGOO M.D.

Table of content: NAOMI ALCOCK PA (NPI 1457342214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184687782 NPI number — DR. SARUPINDER SINGH BHANGOO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BHANGOO
Provider First Name:
SARUPINDER
Provider Middle Name:
SINGH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BHANGOO
Provider Other First Name:
SARUP
Provider Other Middle Name:
SINGH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1184687782
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9508 STOCKDALE HWY
Provider Second Line Business Mailing Address:
SUITE 140 A
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93311-3622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-664-4700
Provider Business Mailing Address Fax Number:
661-664-6787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9508 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE 140 A
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-3622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-664-4700
Provider Business Practice Location Address Fax Number:
661-664-6787
Provider Enumeration Date:
04/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  A402940 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A402940 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110165425 . This is a "RRMEDICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: A402940 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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