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General NPI Number Information
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NPI Number | 1659609311
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Entity Type | Organization
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Legal Business Name | RIVERLAKES SURGERY CENTER LLC
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Dates
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Enumeration Date | 11/18/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 7508 MEANY AVE STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93308-5178
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Country | US
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Telephone | 661-410-0010
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Fax | 661-589-9499
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Provider Business Mailing Address
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Address Line | 7508 MEANY AVE STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93308-5178
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Country | US
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Telephone | 661-410-0010
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Fax | 661-589-9499
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | DAVID BINGLEY HAIR
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Credential | M.D.
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Telephone | 661-410-0010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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