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General NPI Number Information
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NPI Number | 1811016488
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Entity Type | Organization
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Legal Business Name | CALIFORNIA STATE UNIVERSITY BAKERSFIELD
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 9001 STOCKDALE HWY 28HC
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City | BAKERSFIELD
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State | CA
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Zip | 93311-1022
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Country | US
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Telephone | 661-654-3304
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Fax | 661-654-2573
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Provider Business Mailing Address
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Address Line | 9001 STOCKDALE HWY 28HC
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City | BAKERSFIELD
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State | CA
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Zip | 93311-1022
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Country | US
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Telephone | 661-654-3304
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Fax | 661-654-2573
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | ALAN WITHERELL
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Credential | PHARMD
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Telephone | 661-654-3304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | PHE19592
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License Number State | CA
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