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NPI Code Detail

MEDICARE: THOMAS BOUASY P.A.

MEDICARE: THOMAS BOUASY P.A.
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 AssistantPA17818CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AO427YOTHERCAMEDICARE PTAN-TRUXTUN
2AO427XOTHERCAMEDICARE PTAN-URGENT CARE
3AO427ZOTHERCAMEDICARE PTAN-SOUTHWEST

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740269026
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS BOUASY P.A.
Provider Business Mailing Address
First Line : PO BOX 20577
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93390-0577
Country : US
Telephone Number : 661-326-8021
Fax Number : 661-326-8022
Provider Business Practice Location Address
First Line : 400 OLD RIVER RD
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93311-9781
Country : US
Telephone Number : 661-663-6275
Fax Number : 661-326-8022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 05/10/2011

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1407835788 — DR. CHRISTY LYNCH M.D.
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1083693345 — DR. JOHN ERIC FORTENBERRY M.D.
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1659350973 — DR. CHRISTOPHER T. BRADBURN D.O.
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1003895137 — DR. SHANNON K. GRANT M.D.
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Directions to “ THOMAS BOUASY P.A.” Practice Location

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