Healthcare Provider Details

I. General information

NPI: 1750407292
Provider Name (Legal Business Name): GREGORY A. STAINER, MD FACS A PROFESSIONAL MEDICAL CORPATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 CHINA GRADE LOOP
BAKERSFIELD CA
93308-1707
US

IV. Provider business mailing address

215 CHINA GRADE LOOP
BAKERSFIELD CA
93308-1707
US

V. Phone/Fax

Practice location:
  • Phone: 661-393-2331
  • Fax: 661-393-6284
Mailing address:
  • Phone: 661-393-2331
  • Fax: 661-393-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BETTY JANE THOMAS
Title or Position: ADMINISTRATOR
Credential:
Phone: 661-393-2331