Provider Demographics
NPI:1013007285
Name:DAINS, BRUCE G (PAC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:G
Last Name:DAINS
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1139
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1139
Mailing Address - Country:US
Mailing Address - Phone:661-371-2796
Mailing Address - Fax:661-438-1746
Practice Address - Street 1:2701 CHESTER AVE
Practice Address - Street 2:HIGHGROVE MEDICAL CENTER
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301
Practice Address - Country:US
Practice Address - Phone:661-326-1600
Practice Address - Fax:661-323-2307
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13523207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0092950Medicaid
ZZZ01707ZOtherMEDICARE GROUP ID#
CAGR0092950Medicaid
ZZZ01707ZOtherMEDICARE GROUP ID#