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General NPI Number Information
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NPI Number | 1891971727
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Entity Type | Organization
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Legal Business Name | PEDIATRIC HEART CENTER
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 4050 SAN DIMAS ST STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1205
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Country | US
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Telephone | 703-581-7316
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 881750
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City | LOS ANGELES
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State | CA
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Zip | 90009-3010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. AARON ELIJAH BANKS
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Credential |
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Telephone | 703-581-7316
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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 | 200728910152
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License Number State | CA
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