Provider Demographics
NPI:1861672297
Name:GARDEN OASIS MEDICAL WORLD
Entity Type:Organization
Organization Name:GARDEN OASIS MEDICAL WORLD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:YANG
Authorized Official - Last Name:ZONG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:661-487-6325
Mailing Address - Street 1:212 GOODMAN ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-2904
Mailing Address - Country:US
Mailing Address - Phone:661-487-6325
Mailing Address - Fax:
Practice Address - Street 1:212 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-2904
Practice Address - Country:US
Practice Address - Phone:661-487-6325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207LP2900X, 207R00000X
208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty