Healthcare Provider Details

I. General information

NPI: 1346948155
Provider Name (Legal Business Name): JOHN DE ROUEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MILLENNIUM SURGERY CENTER 3850 SAN DIMAS ST
BAKERSFIELD CA
93301
US

IV. Provider business mailing address

PO BOX 2029
BAKERSFIELD CA
93303-2029
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-3700
  • Fax:
Mailing address:
  • Phone: 661-843-7616
  • Fax: 661-760-6926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN DEROUEN
Title or Position: PRESIDENT
Credential:
Phone: 661-204-8106