Healthcare Provider Details

I. General information

NPI: 1336363688
Provider Name (Legal Business Name): SCHAUL SARMICANIC M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 16TH ST SUITE A
BAKERSFIELD CA
93301-5002
US

IV. Provider business mailing address

PO BOX 9368
BAKERSFIELD CA
93389-9368
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-8989
  • Fax:
Mailing address:
  • Phone: 661-326-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberA26261
License Number StateCA

VIII. Authorized Official

Name: SCHAUL SARMICANIC
Title or Position: OWNER
Credential: M.D.
Phone: 661-326-8989