Healthcare Provider Details

I. General information

NPI: 1235122946
Provider Name (Legal Business Name): ALI-REZA BAZMI PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MOUNT VERNON AVE
BAKERSFIELD CA
93306-4018
US

IV. Provider business mailing address

1700 MOUNT VERNON AVE
BAKERSFIELD CA
93306-4018
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-2767
  • Fax: 661-862-7672
Mailing address:
  • Phone: 661-665-9046
  • Fax: 661-862-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number44627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: