Provider Demographics
NPI:1811362908
Name:SHAFTER PEDIATRICS
Entity Type:Organization
Organization Name:SHAFTER PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AYODEJI
Authorized Official - Middle Name:ADETAYO
Authorized Official - Last Name:AYENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-364-5244
Mailing Address - Street 1:PO BOX 22694
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2694
Mailing Address - Country:US
Mailing Address - Phone:661-364-5244
Mailing Address - Fax:
Practice Address - Street 1:501 MUNZER ST
Practice Address - Street 2:SUITE C
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263
Practice Address - Country:US
Practice Address - Phone:661-364-5244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty