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General NPI Number Information
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NPI Number | 1922546019
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Entity Type | Organization
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Legal Business Name | SILLECT CENTER FOR SURGERY LLC
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 3545 SAN DIMAS ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1605
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Country | US
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Telephone | 661-327-2101
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Fax | 661-327-2554
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Provider Business Mailing Address
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Address Line | 2901 SILLECT AVE STE 201
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City | BAKERSFIELD
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State | CA
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Zip | 93308-6373
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Country | US
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Telephone | 661-327-2101
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Fax | 661-327-2101
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIPUL R DEV
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Credential | M.D.
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Telephone | 661-327-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | A063639
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | A063639
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License Number State | CA
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