Healthcare Provider Details

I. General information

NPI: 1740551563
Provider Name (Legal Business Name): PSYCHIATRIC MEDICAL PRACTITIONERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 EYE ST # 100
BAKERSFIELD CA
93301-5208
US

IV. Provider business mailing address

PO BOX 21314
BAKERSFIELD CA
93390-1314
US

V. Phone/Fax

Practice location:
  • Phone: 661-310-3688
  • Fax: 661-368-0826
Mailing address:
  • Phone: 661-310-3688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAGDEEP SINGH GAREWAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 661-310-3688