Provider Demographics
NPI:1043343247
Name:LANGLOIS MEDICAL CORPORATION
Entity Type:Organization
Organization Name:LANGLOIS MEDICAL CORPORATION
Other - Org Name:KERN ISLAND PAIN MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:P
Authorized Official - Last Name:LANGLOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-326-8035
Mailing Address - Street 1:PO BOX 22710
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2710
Mailing Address - Country:US
Mailing Address - Phone:661-326-8035
Mailing Address - Fax:661-326-8037
Practice Address - Street 1:230 S MONTCLAIR ST
Practice Address - Street 2:SUITE101
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3117
Practice Address - Country:US
Practice Address - Phone:661-326-8035
Practice Address - Fax:661-326-8037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG860152081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID
CA=========OtherTAX ID
CAH45118Medicare UPIN
CAZZZ27531ZMedicare PIN