Healthcare Provider Details

I. General information

NPI: 1265783948
Provider Name (Legal Business Name): RHEUMATOLOGY SERVICES MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2012
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8329 BRIMHALL RD STE 801
BAKERSFIELD CA
93312-2243
US

IV. Provider business mailing address

8329 BRIMHALL RD STE 101
BAKERSFIELD CA
93312-2243
US

V. Phone/Fax

Practice location:
  • Phone: 661-695-8385
  • Fax: 661-679-6801
Mailing address:
  • Phone: 661-695-8385
  • Fax: 661-679-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number20A11715
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG29499
License Number StateCA

VIII. Authorized Official

Name: DR. MARTIN BERRY
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 661-695-8385