Healthcare Provider Details

I. General information

NPI: 1023014511
Provider Name (Legal Business Name): HASMUKH C AMIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9508 STOCKDALE HWY STE 150
BAKERSFIELD CA
93311-3623
US

IV. Provider business mailing address

9508 STOCKDALE HWY STE 150
BAKERSFIELD CA
93311-3623
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-7500
  • Fax: 661-663-3063
Mailing address:
  • Phone: 661-663-7500
  • Fax: 661-663-3063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA31121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: