Provider Demographics
NPI:1912394735
Name:BJELLA, KIRK (MD)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:
Last Name:BJELLA
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 1:1515 SPRINGFIELD DR
Mailing Address - Street 2:CHILDREN'S HEALTH CENTER
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928
Mailing Address - Country:US
Mailing Address - Phone:530-781-1440
Mailing Address - Fax:
Practice Address - Street 1:1515 SPRINGFIELD DR
Practice Address - Street 2:CHILDREN'S HEALTH CENTER
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-781-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA157281208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics