Healthcare Provider Details

I. General information

NPI: 1649293572
Provider Name (Legal Business Name): COMPREHENSIVE PEDIATRIC & FAMILY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 COLUMBUS STREET
BAKERSFIELD CA
93305
US

IV. Provider business mailing address

PO BOX 6578
BAKERSFIELD CA
93386
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-5052
  • Fax: 661-862-7635
Mailing address:
  • Phone: 661-326-5052
  • Fax: 661-862-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ABU TALIB TAHER
Title or Position: PRESIDENT
Credential: MD
Phone: 661-326-5052