Healthcare Provider Details

I. General information

NPI: 1992131981
Provider Name (Legal Business Name): BRENT EUGENE BJERKE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 S H ST
BAKERSFIELD CA
93304-6533
US

IV. Provider business mailing address

3315 S H ST
BAKERSFIELD CA
93304-6533
US

V. Phone/Fax

Practice location:
  • Phone: 661-396-0634
  • Fax:
Mailing address:
  • Phone: 661-396-0634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: