Healthcare Provider Details

I. General information

NPI: 1407715501
Provider Name (Legal Business Name): LAITH MOHAMED KORIN BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 YOUNG ST
BAKERSFIELD CA
93311-8896
US

IV. Provider business mailing address

5701 YOUNG ST
BAKERSFIELD CA
93311-8896
US

V. Phone/Fax

Practice location:
  • Phone: 833-831-7946
  • Fax:
Mailing address:
  • Phone: 833-831-7946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: