Healthcare Provider Details

I. General information

NPI: 1508368069
Provider Name (Legal Business Name): OUTPATIENT SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 COMMERCE DRIVE SUITE 203
BAKERSFIELD CA
93309
US

IV. Provider business mailing address

1400 EASTON DR STE 106
BAKERSFIELD CA
93309-9403
US

V. Phone/Fax

Practice location:
  • Phone: 661-324-4100
  • Fax: 661-324-4600
Mailing address:
  • Phone: 661-324-4100
  • Fax: 661-324-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. VINOD KUMAR
Title or Position: DIRECTOR
Credential: MD
Phone: 661-377-2881