Healthcare Provider Details

I. General information

NPI: 1558347393
Provider Name (Legal Business Name): CARLOS F. BAYARDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 10/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 S NEWMARK AVE
PARLIER CA
93648-2531
US

IV. Provider business mailing address

155 S NEWMARK AVE
PARLIER CA
93648-2531
US

V. Phone/Fax

Practice location:
  • Phone: 559-646-1200
  • Fax: 559-646-6622
Mailing address:
  • Phone: 559-646-1200
  • Fax: 559-646-6622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA91684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: