Healthcare Provider Details

I. General information

NPI: 1164992343
Provider Name (Legal Business Name): GEVORGYAN MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2018
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 SAN DIMAS ST STE 14
BAKERSFIELD CA
93301-1694
US

IV. Provider business mailing address

11106 PATAGONIA WAY
BAKERSFIELD CA
93306-7412
US

V. Phone/Fax

Practice location:
  • Phone: 661-522-0043
  • Fax: 661-885-8086
Mailing address:
  • Phone: 323-353-8708
  • Fax: 661-885-8086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GOHAR GEVORGYAN
Title or Position: DIRECTOR
Credential: MD
Phone: 661-522-0043