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General NPI Number Information
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NPI Number | 1477803609
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Entity Type | Organization
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Legal Business Name | RIVERWALK MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 5020 COMMERCE DR STE E
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0631
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Country | US
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Telephone | 661-324-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 EASTON DR SUITE 143
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City | BAKERSFIELD
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State | CA
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Zip | 93309-9412
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Country | US
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Telephone | 661-328-6290
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Fax | 661-631-4310
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. VINOD KUMAR
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Credential | MD
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Telephone | 661-324-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 3498322
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License Number State | CA
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