1336337799 NPI number — MRS. NAOMI KAMIL BJORNSTAD PA-C

Table of content: MRS. NAOMI KAMIL BJORNSTAD PA-C (NPI 1336337799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336337799 NPI number — MRS. NAOMI KAMIL BJORNSTAD PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BJORNSTAD
Provider First Name:
NAOMI
Provider Middle Name:
KAMIL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALVAREZ
Provider Other First Name:
NAOMI
Provider Other Middle Name:
KAMIL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336337799
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5101 SILVER CROSSING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93313-4127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-422-1518
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13646 HIGHWAY 33
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOST HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93249-9719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-797-6691
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2007

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: 363A00000X , with the licence number:  PA19334 , 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)





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