Healthcare Provider Details

I. General information

NPI: 1194316695
Provider Name (Legal Business Name): MICHAEL GEORGE CRT, RRT, BSRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 SILLECT AVE
BAKERSFIELD CA
93308-6337
US

IV. Provider business mailing address

9321 MANOR FOREST LN
SHAFTER CA
93263-9443
US

V. Phone/Fax

Practice location:
  • Phone: 661-316-6000
  • Fax:
Mailing address:
  • Phone: 661-444-1135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number30951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: