MEDICARE: NYD LTD

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
1	207Q00000X	Family Medicine Physician	A24108	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1942293550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYD LTD

Provider Business Mailing Address
First Line	:	904 E BRUNDAGE LN
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93307-3467
Country	:	US
Telephone Number	:	661-327-4279
Fax Number	:	661-325-4216

Provider Business Practice Location Address
First Line	:	904 E BRUNDAGE LN
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93307-3467
Country	:	US
Telephone Number	:	661-327-4279
Fax Number	:	661-325-4216

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JERRY CURTIS FOX
Credential	:	M.D.
Telephone Number	:	661-327-4279

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	07/08/2010

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Directions to “NYD LTD ” Practice Location

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