Healthcare Provider Details

I. General information

NPI: 1407184047
Provider Name (Legal Business Name): SARUPINDER S. BHANGOO,M.D.,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9508 STOCKDALE HWY 140 A
BAKERSFIELD CA
93311-3622
US

IV. Provider business mailing address

9508 STOCKDALE HWY 140 A
BAKERSFIELD CA
93311-3622
US

V. Phone/Fax

Practice location:
  • Phone: 661-664-4700
  • Fax: 661-664-6787
Mailing address:
  • Phone: 661-664-4700
  • Fax: 661-664-6787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA402940
License Number StateCA

VIII. Authorized Official

Name: DR. SARUPINDER S BHANGOO
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D.
Phone: 661-664-4700