Healthcare Provider Details
I. General information
NPI: 1255601746
Provider Name (Legal Business Name): DESIRED BEAUTY SURGICAL & MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2011
Last Update Date: 12/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2020 21ST ST
BAKERSFIELD CA
93301-4220
US
IV. Provider business mailing address
PO BOX 706
PARAMOUNT CA
90723-0706
US
V. Phone/Fax
- Phone: 661-327-4400
- Fax: 661-327-4404
- Phone: 661-327-4400
- Fax: 661-327-4404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0122X |
| Taxonomy | Plastic and Reconstructive Surgery Physician |
| License Number | Z0A7647 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
FARZIN
KERENDIAN
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: D.O., F.A.C.O.S.
Phone: 661-327-4400