Healthcare Provider Details

I. General information

NPI: 1114052263
Provider Name (Legal Business Name): RICK M AJOOTIAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7909 NAIRN CT
BAKERSFIELD CA
93309-4267
US

IV. Provider business mailing address

7909 NAIRN CT
BAKERSFIELD CA
93309-4267
US

V. Phone/Fax

Practice location:
  • Phone: 661-397-3515
  • Fax: 661-397-3515
Mailing address:
  • Phone: 661-397-3515
  • Fax: 661-397-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: