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General NPI Number Information
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NPI Number | 1770299620
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Entity Type | Individual
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Provider Name | FARID ALIPOUR DENTIST
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Gender | Male
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 4190 PINEWOOD LAKE DR
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City | BAKERSFIELD
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State | CA
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Zip | 93309-9319
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Country | US
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Telephone | 661-302-8299
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Fax |
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Provider Business Mailing Address
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Address Line | 4605 BUENA VISTA RD STE 660
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City | BAKERSFIELD
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State | CA
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Zip | 93311-8793
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Country | US
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Telephone | 661-454-7600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 108513
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License Number State | CA
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