Provider Demographics
NPI:1346812161
Name:NISIM SURGICAL
Entity Type:Organization
Organization Name:NISIM SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:AVI
Authorized Official - Last Name:NISIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-748-1886
Mailing Address - Street 1:500 OLD RIVER RD STE 185
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9505
Mailing Address - Country:US
Mailing Address - Phone:661-748-1886
Mailing Address - Fax:661-479-5063
Practice Address - Street 1:500 OLD RIVER RD STE 185
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9505
Practice Address - Country:US
Practice Address - Phone:661-748-1886
Practice Address - Fax:661-479-5063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty