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NPI Code Detail

MEDICARE: CHARLES IKE PA C

MEDICARE:   CHARLES  IKE  PA C
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
1363A00000XPhysician AssistantPA13851CA

General Provider Information

NPI Number : 1366555799
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES IKE PA C
Provider Business Mailing Address
First Line : 815 DR MARTIN LUTHER KING JR BLVD
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93307-1365
Country : US
Telephone Number : 661-322-3905
Fax Number : 661-322-1370
Provider Business Practice Location Address
First Line : 815 DR MARTIN LUTHER KING JR BLVD
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93307-1365
Country : US
Telephone Number : 661-322-3905
Fax Number : 661-322-1370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 09/14/2023

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Directions to “ CHARLES IKE PA C” Practice Location

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