Healthcare Provider Details

I. General information

NPI: 1609665785
Provider Name (Legal Business Name): BAKERSFIELD ASC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 16TH ST STE 507
BAKERSFIELD CA
93301-3454
US

IV. Provider business mailing address

288 N SANTA ANITA AVE STE 402
ARCADIA CA
91006-3183
US

V. Phone/Fax

Practice location:
  • Phone: 800-898-2020
  • Fax:
Mailing address:
  • Phone: 800-898-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TOM CHANG
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 626-676-0838