Healthcare Provider Details

I. General information

NPI: 1689542862
Provider Name (Legal Business Name): PROMEDIX PHLEBOTOMY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 ALONDRA DR
BAKERSFIELD CA
93311-4549
US

IV. Provider business mailing address

10101 ALONDRA DR
BAKERSFIELD CA
93311-4549
US

V. Phone/Fax

Practice location:
  • Phone: 661-215-4626
  • Fax:
Mailing address:
  • Phone: 661-215-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: MARIAN BACULI
Title or Position: CEO
Credential:
Phone: 661-421-0759