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General NPI Number Information
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NPI Number | 1841363736
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Entity Type | Organization
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Legal Business Name | CBCC PAIN MEDICINE AND SURGERY CENTER, INC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 6501 TRUXTUN AVE # 190
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0633
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Country | US
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Telephone | 661-325-8498
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Fax | 661-862-7137
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Provider Business Mailing Address
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Address Line | 6501 TRUXTUN AVE # 190
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0633
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Country | US
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Telephone | 661-325-8498
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Fax | 661-862-7137
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | DIGISHA MODI
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Credential |
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Telephone | 661-862-7105
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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 | 0548691
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License Number State | CA
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