Provider Demographics
NPI:1760014658
Name:BAKERSFIELD COMMONS SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:BAKERSFIELD COMMONS SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GANESH
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHARYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-370-0721
Mailing Address - Street 1:2120 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3709
Mailing Address - Country:US
Mailing Address - Phone:661-748-1935
Mailing Address - Fax:661-478-1935
Practice Address - Street 1:2120 19TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3709
Practice Address - Country:US
Practice Address - Phone:661-748-1905
Practice Address - Fax:661-748-1935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty