Healthcare Provider Details
I. General information
NPI: 1245261262
Provider Name (Legal Business Name): PEDI CENTER, A MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 STOCKDALE HWY SUITE 108
BAKERSFIELD CA
93311-3620
US
IV. Provider business mailing address
9500 STOCKDALE HWY SUITE 108
BAKERSFIELD CA
93311-3620
US
V. Phone/Fax
- Phone: 661-410-9500
- Fax: 661-410-9501
- Phone: 661-410-9500
- Fax: 661-410-9501
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HASMUKH
C.
AMIN
Title or Position: MEDICAL DIRECTOR / PRESIDENT
Credential: M.D.
Phone: 661-410-9500