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General NPI Number Information
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NPI Number | 1750450698
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Entity Type | Organization
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Legal Business Name | CENTRAL NEPHROLOGY MEDICAL GRP INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5030 OFFICE PARK DRIVE SUITE A
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0612
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Country | US
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Telephone | 661-323-2847
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Fax | 661-323-0566
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Provider Business Mailing Address
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Address Line | 5030 OFFICE PARK DRIVE SUITE A
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0612
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Country | US
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Telephone | 661-323-2847
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Fax | 661-323-0566
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MARY ANN BISOGNO
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Credential |
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Telephone | 661-323-2847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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