Healthcare Provider Details
I. General information
NPI: 1043917412
Provider Name (Legal Business Name): JMJLIGON MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/15/2023
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13402 GIRO DR
BAKERSFIELD CA
93314-6646
US
IV. Provider business mailing address
13209 INDURAN DR
BAKERSFIELD CA
93314-6642
US
V. Phone/Fax
- Phone: 310-739-8661
- Fax:
- Phone: 310-739-8661
- Fax: 661-412-4897
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
B
LIGON
Title or Position: CEO
Credential: RN
Phone: 310-739-8661