Healthcare Provider Details

I. General information

NPI: 1487151668
Provider Name (Legal Business Name): PRASHANT P DESAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SILLECT AVE STE 205
BAKERSFIELD CA
93308-6362
US

IV. Provider business mailing address

11905 HARRINGTON ST
BAKERSFIELD CA
93311-9278
US

V. Phone/Fax

Practice location:
  • Phone: 323-328-8904
  • Fax:
Mailing address:
  • Phone: 816-721-1039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA165893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: