Healthcare Provider Details
I. General information
NPI: 1891838470
Provider Name (Legal Business Name): NICHOLAS T. VALOS, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2634 G ST
BAKERSFIELD CA
93301-2814
US
IV. Provider business mailing address
2634 G ST
BAKERSFIELD CA
93301-2814
US
V. Phone/Fax
- Phone: 661-323-8121
- Fax: 661-322-3547
- Phone: 661-323-8121
- Fax: 661-322-3547
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | G47812 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
NICHOLAS
THOMAS
VALOS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 661-323-8121