Healthcare Provider Details

I. General information

NPI: 1114680469
Provider Name (Legal Business Name): ANTONIO SAAVEDRA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 PANAMA LN
BAKERSFIELD CA
93311-9745
US

IV. Provider business mailing address

7311 CUPIO ST
BAKERSFIELD CA
93313-4428
US

V. Phone/Fax

Practice location:
  • Phone: 661-664-0159
  • Fax:
Mailing address:
  • Phone: 818-433-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: