Provider Demographics
NPI:1003976218
Name:BAKERSFIELD SURGERY INSTITUTE
Entity Type:Organization
Organization Name:BAKERSFIELD SURGERY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:III
Authorized Official - Credentials:MPH
Authorized Official - Phone:310-308-9678
Mailing Address - Street 1:9001 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1838
Mailing Address - Country:US
Mailing Address - Phone:310-273-8885
Mailing Address - Fax:310-273-8662
Practice Address - Street 1:9610 STOCKDALE HWY
Practice Address - Street 2:SUITE A
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:91133
Practice Address - Country:US
Practice Address - Phone:661-323-2174
Practice Address - Fax:661-322-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical