Provider Demographics
NPI:1891729653
Name:ETTINGER, VICTOR GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:GEORGE
Last Name:ETTINGER
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 1:2215 TRUXTUN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3602
Mailing Address - Country:US
Mailing Address - Phone:661-840-9270
Mailing Address - Fax:661-864-7848
Practice Address - Street 1:2215 TRUXTUN AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3602
Practice Address - Country:US
Practice Address - Phone:661-840-9270
Practice Address - Fax:661-864-7848
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23420207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G234200Medicaid
CA00G234200Medicare ID - Type Unspecified
CA00G234200Medicaid