Provider Demographics
NPI:1629004957
Name:FELIZARTA, FRANCO ANTONIO B (MD)
Entity Type:Individual
Prefix:
First Name:FRANCO
Middle Name:ANTONIO B
Last Name:FELIZARTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 SAN DIMAS STREET
Mailing Address - Street 2:SUITE 24
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301
Mailing Address - Country:US
Mailing Address - Phone:661-324-3128
Mailing Address - Fax:661-324-3130
Practice Address - Street 1:3535 SAN DIMAS STREET
Practice Address - Street 2:SUITE 24
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93389
Practice Address - Country:US
Practice Address - Phone:661-324-3128
Practice Address - Fax:661-324-3130
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63225207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A632250OtherMEDI-CAL
CA00A632253OtherMEDICARE PROVIDER NUMBER
CAG65426Medicare UPIN