Provider Demographics
NPI:1629101621
Name:BAKERSFIELD PROSTHETICS & ORTHOTICS CENTER, INC.
Entity Type:Organization
Organization Name:BAKERSFIELD PROSTHETICS & ORTHOTICS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:DHOKIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-793-1808
Mailing Address - Street 1:PO BOX 1928
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-1928
Mailing Address - Country:US
Mailing Address - Phone:559-793-1808
Mailing Address - Fax:559-793-2950
Practice Address - Street 1:49 N HOCKETT ST
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257
Practice Address - Country:US
Practice Address - Phone:559-793-1808
Practice Address - Fax:559-793-2950
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PORTERVILLE PROSTHETICS & ORTHOTICS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC15263335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC15263OtherLICENSE
CAXC0022911Medicaid
CAC15263OtherLICENSE