Healthcare Provider Details

I. General information

NPI: 1336071976
Provider Name (Legal Business Name): VYTAL SURGERY CENTER OF BAKERSFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3941 SAN DIMAS ST STE 102
BAKERSFIELD CA
93301-5711
US

IV. Provider business mailing address

3941 SAN DIMAS ST STE 102
BAKERSFIELD CA
93301-5711
US

V. Phone/Fax

Practice location:
  • Phone: 818-578-5125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON COHEN
Title or Position: CEO
Credential: MD
Phone: 818-926-2044