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NPI Code Detail

MEDICARE: ERIK BAKKEN M.D.

MEDICARE: ERIK BAKKEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician56755AZ
2390200000XStudent in an Organized Health Care Education/Training ProgramMT208711PA
3207R00000XInternal Medicine Physician202653CA

General Provider Information

NPI Number : 1053791962
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIK BAKKEN M.D.
Provider Business Mailing Address
First Line : 305 E CENTER AVE # 1913
Second Line :
City : VISALIA
State : CA
Zip : 93291-6331
Country : US
Telephone Number : 480-569-4741
Fax Number :
Provider Business Practice Location Address
First Line : 3425 N 1ST ST
Second Line :
City : FRESNO
State : CA
Zip : 93726-6821
Country : US
Telephone Number : 877-960-3426
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2015
Last Update Date : 05/28/2025

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