Healthcare Provider Details

I. General information

NPI: 1629815352
Provider Name (Legal Business Name): RESHMA MIKKY SHAJI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 02/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MOUNT VERNON AVENUE KERN MEDICAL CENTER
BAKERSFIELD CA
93306
US

IV. Provider business mailing address

1700 MOUNT VERNON AVENUE KERN MEDICAL CENTER
BAKERSFIELD CA
93306
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-2201
  • Fax: 661-326-2950
Mailing address:
  • Phone: 661-326-2201
  • Fax: 661-326-2950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: