San Michael Pediatrics INC
Clinic/Center, Primary Care in Bakersfield, CA. Organization (NPI-2).
NPI number1821292012
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1821292012
- Entity type
- Organization (NPI-2)
- Legal business name
- San Michael Pediatrics INC
- Organization subpart
- No
- Enumeration date
- Jun 12, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | A84684 | CA | Yes |
Practice location
3612 Coffee Rd Ste CBakersfield, CA 93308-5027
Phone 661-587-6464
Mailing address
3612 Coffee Rd Ste CBakersfield, CA 93308-5027
Phone 661-587-6464
Authorized official
Emad Farid Shafic
Officer
6615876464
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