Provider Demographics
NPI:1003959313
Name:BAKERSFIELD BARIATRICS MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BAKERSFIELD BARIATRICS MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRAV
Authorized Official - Middle Name:C
Authorized Official - Last Name:NAIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-447-4559
Mailing Address - Street 1:4817 CENTENNIAL PLAZA WAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-1957
Mailing Address - Country:US
Mailing Address - Phone:661-447-4559
Mailing Address - Fax:661-447-4565
Practice Address - Street 1:4817 CENTENNIAL PLAZA WAY
Practice Address - Street 2:SUITE C
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-1957
Practice Address - Country:US
Practice Address - Phone:661-447-4559
Practice Address - Fax:661-447-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208600000X
CAA67017208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH55222Medicare UPIN