Healthcare Provider Details

I. General information

NPI: 1952425936
Provider Name (Legal Business Name): PADMAJA REDDY KANKAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PADMAJA MOSALI MBBS

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 1ST ST
BAKERSFIELD CA
93304-2901
US

IV. Provider business mailing address

1611 1ST ST
BAKERSFIELD CA
93304-2901
US

V. Phone/Fax

Practice location:
  • Phone: 661-336-5300
  • Fax: 661-336-5303
Mailing address:
  • Phone: 661-336-5300
  • Fax: 661-336-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA98001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: