Healthcare Provider Details

I. General information

NPI: 1215627328
Provider Name (Legal Business Name): DYLAN BAILEY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 DISTRICT BLVD UNIT A
BAKERSFIELD CA
93313-4845
US

IV. Provider business mailing address

3400 CALLOWAY DR STE 603
BAKERSFIELD CA
93312-2514
US

V. Phone/Fax

Practice location:
  • Phone: 661-873-7975
  • Fax: 661-616-6199
Mailing address:
  • Phone: 661-873-7975
  • Fax: 661-616-9199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT304070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: