=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093975617
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOREEN TADOKORO D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2008
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2031 17TH ST STE 1
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93301-4203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-843-7673
-----------------------------------------------------
Fax | 661-843-7674
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2031 17TH ST STE 1
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93301-4203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-843-7673
-----------------------------------------------------
Fax | 661-843-7674
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 20A12044
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------