1457783938 NPI number — NEPHROLOGY MEDICAL GROUP OF BAKERSFIELD INC

Table of content: (NPI 1457783938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457783938 NPI number — NEPHROLOGY MEDICAL GROUP OF BAKERSFIELD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEPHROLOGY MEDICAL GROUP OF BAKERSFIELD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1457783938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 80484
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:
93380-0484
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-322-2070
Provider Business Mailing Address Fax Number:
661-322-2330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3933 COFFEE RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308-5024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-2070
Provider Business Practice Location Address Fax Number:
661-322-2330
Provider Enumeration Date:
08/06/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BRAR
Authorized Official First Name:
HARJEET
Authorized Official Middle Name:
KIDNEY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
661-396-7100

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com