Healthcare Provider Details

I. General information

NPI: 1467950493
Provider Name (Legal Business Name): ALAN LIEN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 03/16/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 OLD RIVER RD STE 125
BAKERSFIELD CA
93311-9506
US

IV. Provider business mailing address

300 OLD RIVER RD STE 125
BAKERSFIELD CA
93311-9506
US

V. Phone/Fax

Practice location:
  • Phone: 661-322-2700
  • Fax: 661-427-4587
Mailing address:
  • Phone: 661-322-2700
  • Fax: 661-427-4587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0387
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60653
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: