Healthcare Provider Details

I. General information

NPI: 1972528552
Provider Name (Legal Business Name): WEDAD MENRIT RIZKALLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 COLUMBUS ST
BAKERSFIELD CA
93305
US

IV. Provider business mailing address

PO BOX 6578
BAKERSFIELD CA
93386-6578
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 TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA38657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: