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General NPI Number Information
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NPI Number | 1346812161
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Entity Type | Organization
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Legal Business Name | NISIM SURGICAL
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 500 OLD RIVER RD STE 185
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9505
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Country | US
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Telephone | 661-748-1886
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Fax | 661-479-5063
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Provider Business Mailing Address
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Address Line | 500 OLD RIVER RD STE 185
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9505
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Country | US
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Telephone | 661-748-1886
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Fax | 661-479-5063
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ABRAHAM AVI NISIM
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Credential | MD
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Telephone | 661-748-1886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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