Provider Demographics
NPI:1609038256
Name:VAHDATYAR AMIRPOUR M.D. INC
Entity Type:Organization
Organization Name:VAHDATYAR AMIRPOUR M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIRPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-327-2500
Mailing Address - Street 1:PO BOX 380
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-0380
Mailing Address - Country:US
Mailing Address - Phone:661-327-2500
Mailing Address - Fax:661-327-7090
Practice Address - Street 1:2501 H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2817
Practice Address - Country:US
Practice Address - Phone:661-327-2500
Practice Address - Fax:661-327-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44475207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A444750Medicaid
CA00A444750Medicaid
CA00A444750Medicare PIN