Provider Demographics
NPI:1932528908
Name:SRIVASTAVA, KARAN
Entity Type:Individual
Prefix:MR
First Name:KARAN
Middle Name:
Last Name:SRIVASTAVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 LEXINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-3696
Mailing Address - Country:US
Mailing Address - Phone:661-544-3352
Mailing Address - Fax:661-544-3432
Practice Address - Street 1:9610 STOCKDALE HWY UNIT C
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3626
Practice Address - Country:US
Practice Address - Phone:661-544-3352
Practice Address - Fax:661-544-3432
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA168067207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty