Healthcare Provider Details

I. General information

NPI: 1538221874
Provider Name (Legal Business Name): GIRMAY Y GEBREMEDHIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 34TH ST
BAKERSFIELD CA
93301-2237
US

IV. Provider business mailing address

6401 TRUXTUN AVE
BAKERSFIELD CA
93309-0613
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-5350
  • Fax: 661-321-9803
Mailing address:
  • Phone: 661-327-0739
  • Fax: 661-631-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA98285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: