Healthcare Provider Details

I. General information

NPI: 1144047507
Provider Name (Legal Business Name): SILVER SUMMIT MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 COMMERCE DR STE B
BAKERSFIELD CA
93309-0631
US

IV. Provider business mailing address

PO BOX 743529
LOS ANGELES CA
90074-3530
US

V. Phone/Fax

Practice location:
  • Phone: 661-727-0000
  • Fax: 661-374-8004
Mailing address:
  • Phone: 661-727-0000
  • Fax: 661-324-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. VINOD KUMAR
Title or Position: PRESIDENT
Credential: MD
Phone: 661-204-2222