Healthcare Provider Details

I. General information

NPI: 1780950543
Provider Name (Legal Business Name): ALAN F DAKAK MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 34TH ST SUITE 202
BAKERSFIELD CA
93301-2283
US

IV. Provider business mailing address

820 34TH ST SUITE 202
BAKERSFIELD CA
93301-2283
US

V. Phone/Fax

Practice location:
  • Phone: 661-864-7944
  • Fax: 661-864-7946
Mailing address:
  • Phone: 661-864-7944
  • Fax: 661-864-7946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA96755
License Number StateCA

VIII. Authorized Official

Name: ALAN F DAKAK
Title or Position: PRESIDENT
Credential: MD
Phone: 661-864-7944