=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457515181
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAKERSFIELD EYE INSTITUTE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2008
-----------------------------------------------------
Last Update Date | 04/30/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7508 MEANY AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93308-5178
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-589-9400
-----------------------------------------------------
Fax | 661-589-9499
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7508 MEANY AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-589-9400
-----------------------------------------------------
Fax | 661-589-9499
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR/OWNER
-----------------------------------------------------
Name | DR. DAVID B HAIR
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 661-589-9400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | A96015
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------