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NPI Code Detail

MEDICARE: KOMAL DESAI M.D.

MEDICARE: KOMAL DESAI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianA71331CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A71331OTHERCALICENSE

General Provider Information

NPI Number : 1144217506
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOMAL DESAI M.D.
Provider Business Mailing Address
First Line : 2600 BERESFORD PL
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93311-9272
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1600 E BELLE TER
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93307-3871
Country : US
Telephone Number : 661-201-4239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 03/18/2021

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