Healthcare Provider Details

I. General information

NPI: 1821662545
Provider Name (Legal Business Name): NIBBANA HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 04/28/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1522 18TH ST STE 207
BAKERSFIELD CA
93301-4432
US

IV. Provider business mailing address

1522 18TH ST STE 207
BAKERSFIELD CA
93301-4432
US

V. Phone/Fax

Practice location:
  • Phone: 805-791-7167
  • Fax: 818-356-4380
Mailing address:
  • Phone: 805-791-7167
  • Fax: 339-707-9017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NIRMAL SINGH
Title or Position: PRESIDENT&CEO
Credential: MD
Phone: 805-791-7167