Provider Demographics
NPI:1023120490
Name:DELANO SURGICAL GROUP
Entity type:Organization
Organization Name:DELANO SURGICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHISHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-725-4847
Mailing Address - Street 1:1205 GARCES HWY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-3639
Mailing Address - Country:US
Mailing Address - Phone:661-725-4847
Mailing Address - Fax:661-725-8051
Practice Address - Street 1:1205 GARCES HWY
Practice Address - Street 2:SUITE 303
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3639
Practice Address - Country:US
Practice Address - Phone:661-725-4847
Practice Address - Fax:661-725-8051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID