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General NPI Number Information
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NPI Number | 1821861881
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Entity Type | Organization
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Legal Business Name | GREGORY R KLIS MD INC
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 8339 BRIMHALL RD STE 1303
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City | BAKERSFIELD
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State | CA
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Zip | 93312-4088
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Country | US
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Telephone | 661-829-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 8339 BRIMHALL RD STE 1303
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City | BAKERSFIELD
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State | CA
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Zip | 93312-4088
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Country | US
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Telephone | 661-829-0026
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY R KLIS
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Credential | MD
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Telephone | 661-340-0626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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