Healthcare Provider Details

I. General information

NPI: 1972665222
Provider Name (Legal Business Name): ALAN AFSHIN ESLA DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OLD RIVER RD SUITE# 275
BAKERSFIELD CA
93311-9504
US

IV. Provider business mailing address

500 OLD RIVER RD SUITE# 275
BAKERSFIELD CA
93311-9504
US

V. Phone/Fax

Practice location:
  • Phone: 661-616-0202
  • Fax: 661-616-0203
Mailing address:
  • Phone: 661-616-0202
  • Fax: 661-616-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberA76953
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number43529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: