1407261910 NPI number — TAMER SAID BAKHOOM SR.

Table of content: TAMER SAID BAKHOOM SR. (NPI 1407261910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407261910 NPI number — TAMER SAID BAKHOOM SR.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAKHOOM
Provider First Name:
TAMER
Provider Middle Name:
SAID
Provider Name Prefix Text:
Provider Name Suffix Text:
SR.
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407261910
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1425 S H 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:
93304-4512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-833-1680
Provider Business Mailing Address Fax Number:
661-833-1510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
631 GRAHAM PEAK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93314-4296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-364-8979
Provider Business Practice Location Address Fax Number:
661-833-1510
Provider Enumeration Date:
06/23/2014

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: 183500000X , with the licence number:  65053 , 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)