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General NPI Number Information
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NPI Number | 1881994580
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Entity Type | Organization
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Legal Business Name | BAKERSFIELD UROLOGIC ASSOCIATES INC
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 6001 TRUXTUN AVE # B SUITE 220
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-323-6660
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Fax | 661-323-3435
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Provider Business Mailing Address
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Address Line | 6001 TRUXTUN AVE # B SUITE 220
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-323-6660
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Fax | 661-323-3435
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Authorized Official
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Title or Position | OWNER
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Name | BRUCE JAY JOSEPH
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Credential | M.D.
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Telephone | 661-323-6660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G302830
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License Number State | CA
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