Healthcare Provider Details

I. General information

NPI: 1841292026
Provider Name (Legal Business Name): ANA AMPARO CARDENAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CALLOWAY DR STE 200
BAKERSFIELD CA
93312-2513
US

IV. Provider business mailing address

3400 CALLOWAY DR STE 200
BAKERSFIELD CA
93312-2513
US

V. Phone/Fax

Practice location:
  • Phone: 661-410-7546
  • Fax: 661-410-7547
Mailing address:
  • Phone: 661-410-7546
  • Fax: 661-410-7547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG86302
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberG86302
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: